P0451 Can we identify colorectal cancer earlier and prevent emergency presentation?

Aim: 22% of colorectal cancers are diagnosed as an emergency and these patients have worse outcomes compared to those diagnosed via other routes. Population data demonstrates that such patients have warning signs and frequently attend A&E up to 2 years prior to diagnosis with non-specific symptoms, especially those from deprived backgrounds. This study aims to assess our patient's outcomes and identify opportunities to diagnose their cancer earlier. Methods: All emergency colorectal cancers presenting as an emergency from August 2022 - August 2024 at a single centre were identified. Exclusion criteria included appendiceal/ small bowel tumours and known (palliated) cancers. Primary outcomes were 30 day/ 1 year mortality. Secondary outcomes were previous attendances to A&E, endoscopy, FIT levels and anaemia within 2 years of diagnosis. Results: 125 patients were included (71M, 54F). Median age was 74 (23-93). 61.6% (n = 77) of patients underwent surgery of these 70 patients underwent resectional surgery, 6 were defunctioned and 1 had bypass surgery.; 30-day mortality for all patients was 8.8% (n = 11), 1-year mortality was 44.2% (patients admitted >1 year ago n = 46/104). Within 2 years prior to diagnosis; 32% (n = 40) of patients presented to A&E, 15.2% (n = 19) had a documented qFIT >10, 34.4% (n = 43) were anaemic, 4% (n = 5) had undergone endoscopy. Conclusion: Given our hospital's demography it is unsurprising that many are attending hospital prior to diagnosis as per the population data. We are now undertaking a prospective study working with newly diagnosed patients to identify barriers to earlier presentation and how we can overcome these.

Citation

Walker et al (2025). P0451 Can we identify colorectal cancer earlier and prevent emergency presentation? Colorectal Disease. 27 (S1): e70174. https://doi.org/10.1111/codi.70174

DOI

10.1111/codi.70174

URI

https://hdl.handle.net/20.500.14709/1126

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Free access to article on publisher's webpage. Click DOI.

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