Emergency colorectal cancer: Primary care input

Published Date: 19th July 2016

Publication Authors: Rajaganeshan R, Scott M

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Introduction

Higher morbidity and mortality is seen in patients with colorectal cancer (CRC) who present as an emergency. A study was performed to assess the pre-admission symptoms experienced by such patients, and time taken to referral.

Method

A retrospective analysis of all CRC patients presenting as an emergency to a single District General Hospital during 2012 was performed. Patients were questioned about their pre-admission symptoms and their attendance to their primary care physicians.

Results

29 patients were admitted as emergencies and received emergency surgery. The mean age was 72.6 years (range 23-89) 86% of patients had pre-admission symptoms, usually abdominal pain (56%), with a mean duration of 29 weeks (range 1-52 weeks). None complained of rectal bleeding. 59% of all patients had consulted their GP with symptoms, 71% more than once and 35% more than 5 times. Of the patients seen by a GP 29% were referred to the local hospital outpatient department and all but one through the rapid access service, although none satisfied the local criteria.

Conclusions

The majority of CRC patients presenting to hospital as an emergency have had symptoms, usually abdominal pain, for a considerable amount of time. Two thirds of patients had seen their GP with their symptoms, of which over a third had been 5 times or more. A lower threshold of referral for abdominal pain should be considered by primary care. If patients were referred earlier perhaps fewer would present as emergencies.

Grainger, J; Hamoodi, Z; Rajaganeshan, R; Scott, M. (2014).  Emergency colorectal cancer: Primary care input . Colorectal Disease. 16 (Supplement S2), 72.

 

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