ArticleBritish journal of cancer2022
Do presenting symptoms, use of pre-diagnostic endoscopy and risk of emergency cancer diagnosis vary by comorbidity burden and type in patients with colorectal cancer?
Article in British journal of cancer, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.
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The trial behind it
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Who cites it
16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Pooled it
- Clinical Delays and Comparative Outcomes in Younger and Older Adults with Colorectal Cancer: A Systematic Review.Current oncology (Toronto, Ont.) · 2022Pooled it
- Time to diagnosis and treatment in younger adults with colorectal cancer: A systematic review.PloS one · 2022Pooled it
- Age-stratified risk profiles for emergency colorectal cancer resection: A machine-learning analysis.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2026Article
- Article
- Metabolic Multimorbidity and Acute Obstructive Presentation in Colon Cancer: A 677-Patient Hospital-Based Cohort.Journal of clinical medicine · 2025Article
- Cancer stage at diagnosis by duration of pre-existing chronic analgesic use and anxiety or depression.Nature communications · 2025Article
- Comorbidities, Socioeconomic Status, and Colorectal Cancer Diagnostic Route.JAMA network open · 2025Article
- Perceptions of the Impact of Comorbidity on the Bowel Cancer Screening Programme: Qualitative Study With Bowel Screening Participants and Staff.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- What can hospital emergency admissions prior to cancer diagnosis tell us about socio-economic inequalities in cancer diagnosis? Evidence from population-based data in England.British journal of cancer · 2024Article
- Implementation and external validation of the Cambridge Multimorbidity Score in the UK Biobank cohort.BMC medical research methodology · 2024Article
- Phenotypes and rates of cancer-relevant symptoms and tests in the year before cancer diagnosis in UK Biobank and CPRD Gold.PLOS digital health · 2023Article
- Effects of gender and socio-environmental factors on health-care access in oncology: a comprehensive, nationwide study in France.EClinicalMedicine · 2023Article
- Article
- Measurement of clinical delay intervals among younger adults with colorectal cancer using health administrative data: a population-based analysis.BMJ open gastroenterology · 2022Article
- Mental Health Morbidities and Time to Cancer Diagnosis Among Adults With Colon Cancer in England.JAMA network open · 2022Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundCancer patients often have pre-existing comorbidities, which can influence timeliness of cancer diagnosis. We examined symptoms, investigations and emergency presentation (EP) risk among colorectal cancer (CRC) patients by comorbidity status.
methodsUsing linked cancer registration, primary care and hospital records of 4836 CRC patients (2011-2015), and multivariate quantile and logistic regression, we examined variations in specialist investigations, diagnostic intervals and EP risk.
resultsAmong colon cancer patients, 46% had at least one pre-existing hospital-recorded comorbidity, most frequently cardiovascular disease (CVD, 18%). Comorbid versus non-comorbid cancer patients more frequently had records of anaemia (43% vs 38%), less frequently rectal bleeding/change in bowel habit (20% vs 27%), and longer intervals from symptom-to-first relevant test (median 136 vs 74 days). Comorbid patients were less likely investigated with colonoscopy/sigmoidoscopy, independently of symptoms (adjusted OR = 0.7[0.6, 0.9] for Charlson comorbidity score 1-2 and OR = 0.5 [0.4-0.7] for score 3+ versus 0. EP risk increased with comorbidity score 0, 1, 2, 3+: 23%, 35%, 33%, 47%; adjusted OR = 1.8 [1.4, 2.2]; 1.7 [1.3, 2.3]; 3.0 [2.3, 4.0]) and for patients with CVD (adjusted OR = 2.0 [1.5, 2.5]).
conclusionsComorbid individuals with as-yet-undiagnosed CRC often present with general rather than localising symptoms and are less likely promptly investigated with colonoscopy/sigmoidoscopy. Comorbidity is a risk factor for diagnostic delay and has potential, additionally to symptoms, as risk-stratifier for prioritising patients needing prompt assessment to reduce EP.
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