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Emergency presentation of colon cancer is most frequent during summer
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centrum för klinisk forskning i D län (CKFD).
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centrum för klinisk forskning i D län (CKFD).
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centrum för klinisk forskning i D län (CKFD).
2011 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 13, no 6, p. 663-668Article in journal (Refereed) Published
Abstract [en]

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%; chi 2 = 9.4, P < 0.001) and had a cancer located in the caecum less often (20% vs 33%, chi 2 = 4.3 P = 0.04). ECC were most frequent between June and August (36%), whereas elective cases were evenly distributed throughout the year (chi 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.

Place, publisher, year, edition, pages
2011. Vol. 13, no 6, p. 663-668
Keywords [en]
Colon cancer, emergency, stage, population-based, survival, risk factors
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-154301DOI: 10.1111/j.1463-1318.2010.02270.xISI: 000290451400024PubMedID: 20345966OAI: oai:DiVA.org:uu-154301DiVA, id: diva2:419873
Available from: 2011-05-30 Created: 2011-05-30 Last updated: 2017-12-11Bibliographically approved

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