RISK-FACTORS IN PATIENTS PRESENTING AS AN EMERGENCY WITH COLORECTAL-CANCER

Of 905 patients with colorectal cancer admitted to a single district g eneral hospital, 272 (30 per cent) were admitted as emergencies. Emerg ency patients had more advanced tumours (Dukes stage B and C 96 per ce nt versus 88 per cent of those admitted electively, P < 0.006), a shor ter history (median 3 versus 11 weeks, P < 0.0001), were less likely t o be fully ambulatory (44 versus 80 per cent, P < 0.0001) and more lik ely to have abdominal pain (74 versus 51 per cent, P < 0.001) and vomi ting (40 versus 10 per cent, P < 0.0001). More emergency patients were given stomas (56 versus 35 per cent, P < 0.0001) and died in hospital (19 versus 8 per cent, P < 0.0001). Of those who survived to be disch arged, patients admitted as an emergency spent longer in hospital (med ian stay 16 versus 13 days, P < 0.0001) and had a poorer overall 5-yea r survival rate (29 versus 39 per cent, P = 0.0001). Emergency patient s were significantly older (median 74 versus 72 years, P = 0.04) and m uch more likely to be widowed (41 versus 27 per cent, P = 0.0002) than those admitted for elective surgery. If the personal and resource dis aster of emergency colorectal cancer admission is to be reduced, scree ning strategies targeted by demographic characteristics require invest igation.