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Emergency presentation of colon cancer is most frequent during summer
Author(s) -
Gunnarsson H.,
Holm T.,
Ekholm A.,
Olsson L. I.
Publication year - 2011
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2010.02270.x
Subject(s) - medicine , hazard ratio , colorectal cancer , proportional hazards model , cancer , emergency department , presentation (obstetrics) , risk factor , surgery , pediatrics , confidence interval , psychiatry
Aim The frequency of emergency colon cancer (ECC) was determined using a reproducible definition of ‘emergency’ to analyse the impact of mode of presentation on long‐term prognosis and to search for risk factors for an emergency presentation. Method All patients with colon cancer treated at one Swedish GDH between 1996 and 2005 ( N = 604) were eligible. Patients admitted through the emergency room, operated on within three days and with an emergency condition confirmed at surgery were classified as ECC. Survival was analysed by Kaplan–Meier estimates and risk of death by Cox regression. Results The rate of ECC was 97/585 (17%). Patients with ECC were older (median 77 vs 74, P = 0.02), they had more stage III and IV cancers (65% vs 47%; χ 2 = 9.4, P < 0.001) and had a cancer located in the caecum less often (20% vs 33%, χ 2 = 4.3 P = 0.04). ECC were most frequent between June and August (36%), whereas elective cases were evenly distributed throughout the year (χ 2 = 7.8; P = 0.049), Crude 5‐year survival was 18% in ECC and 38% in the elective group ( P < 0.001). The hazard ratio for death within five years in ECC, with 30‐day mortality excluded and adjusted for age and sex was 2.25 (95% CI; 1.42–3.55). Conclusion Emergency presentation of colon cancer is an independent and adverse risk factor for long‐term survival. The causes of a seasonal variation need to be clarified.