Skip Navigation



Family Practice Advance Access published online on November 30, 2006
Family Practice, doi:10.1093/fampra/cml059
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
24/1/3    most recent
cml059v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Cleary, J.
Right arrow Articles by Hamilton, W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Cleary, J.
Right arrow Articles by Hamilton, W.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author (2006). Published by Oxford University Press. All rights reserved.
Received July 25, 2006
Accepted October 17, 2006

Article

Clinical features of colorectal cancer before emergency presentation: a population-based case-control study

Jonathan Cleary 1, Tim J. Peters 1, Deborah Sharp 1, and William Hamilton 1 *

1 Academic Unit of Primary Health Care, Department of Community Based Medicine, University of Bristol, The Grange, 1 Woodland Road, Bristol BS8 1AU, UK

* To whom correspondence should be addressed.
William Hamilton, E-mail: w.hamilton{at}bristol.ac.uk


  Abstract

Objective. To identify the clinical features of colorectal cancer presenting as a surgical emergency.

Design. Population-based case-control study.

Setting. All general practices in Exeter Primary Care Trust, Devon, UK.

Participants. 349 patients with colorectal cancer, 62 of these having an emergency presentation. Five randomly selected controls matched by age, sex and general practice for each case.

Data. The entire primary care record, from 24 months to 30 days before diagnosis, was coded using the International Classification of Primary Care-2.

Main outcome measures. Symptom reporting by patients with emergency presentation of colorectal cancer compared with matched controls and non-emergency presentations.

Results. Eight features of colorectal cancer were associated with the 62 emergency presentations of colorectal cancer. 39 (63%) of patients had reported at least one symptom to their doctors a minimum of 30 days before the diagnosis. In multivariable analysis, three features remained independently associated with cancer: abdominal pain, odds ratio 6.2 (95% CI 2.8-14), P < 0.001; loss of weight 3.4 (1.3-8.5), P = 0.01; and diarrhoea 3.4 (1.2-5.7), P = 0.02. When emergency presentations were compared with elective cases, abdominal pain was more common [interaction odds ratio 2.3 (1.6-3.3); P = 0.047] and rectal bleeding less common [0.30 (0.08, 1.0); P = 0.040].

Conclusion. The majority of patients destined to have an emergency presentation of colorectal cancer have reported symptoms of their cancer to their doctor well before the emergency. Some emergency presentations should therefore be preventable.

Keywords: Colorectal cancer; diagnosis; emergency admissions; primary health care.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.