Comorbidities Tied to Emergency CRC Diagnoses
A substantial proportion of colorectal cancer (CRC) cases were diagnosed through emergency presentations, with increased odds observed among patients younger than 50 years or aged 80 years or older, those with a lower socioeconomic status, individuals who were widowed, and those with three or more comorbidities.
METHODOLOGY:
Emergency diagnoses of cancer are associated with poorer survival rates. Given that socioeconomic status and comorbidities can influence diagnostic pathways, evaluating these factors is vital for improving care.
Researchers conducted a retrospective cohort study using data from an Italian cancer registry linked to administrative health databases to examine how comorbidities and socioeconomic status affect CRC diagnostic routes; cases were diagnosed between July 2014 and December 2020.
Three mutually exclusive diagnostic routes were examined: Screening, emergency presentation, and inpatient or outpatient visits. Researchers also assessed cancer stage at diagnosis and short-term mortality.
TAKEAWAY:
Researchers included 14,457 patients diagnosed with CRC (74.4% with colon cancer and 25.6% with rectal cancer).
D iagnostic routes were reconstructed for 97.8% of patients with colon cancer (median age, 73.1 years; 47.1% women) and 98.1% of those with rectal cancer (median age, 70.3 years; 42.8% women).
Among colon cancer cases, 35.6% were diagnosed via emergency presentation, 8.4% via screening, and 22.6% during inpatient/outpatient visits. For rectal cancer, the corresponding rates were 22.6%, 9.5%, and 67.8%, respectively.
Emergency diagnosis of colon cancer was more likely among patients younger than 50 years or aged 80 years or older, those in the highest deprivation socioeconomic index quintile, single or widowed individuals (vs married), and those with three or more comorbidities (vs none).
Conversely, patients with three or more comorbidities were less likely to be diagnosed with colon cancer through screening than during inpatient/outpatient visits.
For both colon and rectal cancers, diagnosis through emergency presentations was associated with significantly higher 30-day and 1-year mortalities than diagnosis through inpatient/outpatient visits ( P < .001 for all).
IN PRACTICE:
'Tailored interventions are needed to facilitate screening, to reduce emergency cancer diagnoses, and to improve outcomes for a large number of patients with chronic conditions,' the authors wrote.
SOURCE:
This study was led by Flavia Pennisi, MD, School of Medicine, University Vita-Salute San Raffaele, Milan, Italy. It was published online in JAMA Network Open .
LIMITATIONS:
The lack of individual-level electronic health records limited access to symptom data at diagnosis, hindering the ability to differentiate between symptomatic and asymptomatic cases. This study focused on observed associations rather than causal relationships.
DISCLOSURES:
This study was funded by a grant and an award from Early Detection and Diagnosis Committee from Cancer Research UK. The authors reported having no conflicts of interest.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Health Line
2 hours ago
- Health Line
Can You Catch Pneumonia?
While pneumonia, an infection in the lungs, itself isn't contagious, the viruses and bacteria that cause it often are. People with weakened immune systems may be at a greater risk from contagious causes of pneumonia. Pneumonia is an infection that occurs in your lungs. While you can't catch pneumonia, you may be able to catch what caused someone's pneumonia. Sometimes, pneumonia is caused by viruses or bacteria that can be transmitted from person to person. However, pneumonia may also be caused by conditions that are not contagious, such as inhaled food that becomes trapped in the lungs or environmental factors like fungus. Read on to learn more about the causes of pneumonia, when they may be contagious, and what you can do to prevent catching a virus or bacterial infection. Is pneumonia contagious? Yes, certain types of pneumonia are contagious. Pneumonia is caused by bacteria, viruses, fungi or foreign bodies. Some of these causes may be transmitted from person to person, but not everyone who is exposed will develop pneumonia. Some types of pneumonia are caused by things that can't be transmitted to other people. Bacterial pneumonia can be transmitted from person to person. Forms of bacterial pneumonia include: walking pneumonia streptococcal pneumonia pneumonia caused by Chlamydia pneumoniae pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA) There are many viruses that can cause pneumonia, including the same viruses that cause the cold and flu. Viruses can pass from person to person easily. For example, the influenza virus can survive on surfaces, making it even more contagious. Other viruses that attack the respiratory system can be contagious as well. Noncontagious pneumonia Fungal pneumonia and aspiration pneumonia are examples of pneumonia that aren't usually contagious. Fungal pneumonia is caused by inhaled fungi from the environment. It does not spread from person to person. The fungi that cause this type of pneumonia are usually found in soil. Aspiration pneumonia isn't contagious because it's caused by inhaling food or liquid into your lungs. This can happen in people who've had a stroke or have other neurologic conditions. How is pneumonia spread? Most cases of pneumonia are caused by either bacterial or viral organisms. These can spread in a number of ways, including: coughs or sneezes that aren't covered not wearing a mask when sick sharing cups or eating utensils touching a tissue or other item after someone with bacterial or viral pneumonia has used it, then touching your face. not washing your hands regularly, especially after blowing your nose, coughing, or sneezing How can you prevent the spread of pneumonia? Here are some steps that can help reduce your exposure to the bacteria or viruses that can cause pneumonia. Tips for preventing pneumonia Wash your hands regularly, especially if you're caring for someone who has pneumonia. Get vaccinated. Avoid smoking, or get help to quit. Keep your body in good health with exercise and a nutritious, balanced diet. If you have any ongoing health conditions, take all medications as prescribed. When possible, try to limit contact with people who are sick. If you have pneumonia yourself, stay home until you're well and a doctor says your pneumonia is no longer contagious. What are the symptoms of pneumonia? Symptoms of pneumonia include: fever sweating chills a wet cough that produces colored or clear phlegm loss of appetite fatigue nausea and vomiting difficulty breathing Call a doctor if you think an illness may be pneumonia and you're in a high risk category. And contact a medical professional if you have: chest pain cough lasting more than 1 week difficulty breathing or shortness of breath a fever over 100.4˚F (38˚C) for more than 3 days, since most fevers go away in this time worsening symptoms What vaccines are available for pneumonia? Vaccines are an important and effective way to prevent both bacterial and viral infections in children and adults. Pneumonia is a common complication of many of these infections. Other helpful vaccines for children include: DTaP and Tdap, which both protect against diphtheria, tetanus, and pertussis (whooping cough) flu Haemophilus influenzae type b (Hib) measles, mumps, and rubella (MMR) meningitis pneumococcal conjugate vaccine for Streptococcal pneumonia Other helpful vaccines for adults include: flu meningitis pneumococcal conjugate vaccine or pneumococcal polysaccharide vaccine for Streptococcal pneumonia shingles Tdap varicella (chickenpox) Speak with your doctor about which vaccines are right for you and your family. Who is most at risk of getting pneumonia? Not everyone who's exposed to these bacteria or viruses will develop pneumonia. People who are at high risk of developing pneumonia include: children under 2 years old adults over 65 years old pregnant people anyone with a weakened immune system (immunocompromised), such as people who have HIV or AIDS or an autoimmune disease, or who are undergoing chemotherapy people with a chronic condition, such as diabetes or heart disease people with lung disease, such as chronic obstructive pulmonary disease (COPD) or asthma people who smoke people who've been hospitalized Q&A: Can pneumonia be contagious to babies? Q: Can my baby catch our relative's pneumonia? Anonymous reader A: Pneumonia can be transmitted from an adult with pneumonia to a baby by coughing, sneezing, and close contact. Babies are not immunized against pneumonia until age 2. Therefore, they are at greater risk. A few things adults can do to reduce this risk include: covering mouth and nose when coughing and sneezing washing hands frequently with soap and water limiting close contact not kissing baby's bare skin Chris Young, DNP, RN, NE-BC, NPD Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice. Takeaway While you can't catch pneumonia, depending on the type of pneumonia, you can catch what caused it. Bacterial and viral pneumonia are the most common types of pneumonia. They're both contagious. However, you can reduce your risk of developing these pneumonias by getting vaccinated and practicing proper hand hygiene, among other steps. If you do develop pneumonia, effective treatments are available. A doctor will prescribe antibiotics to treat bacterial pneumonia. In most cases, your pneumonia should no longer be contagious 24 hours after starting antibiotics, and once your fever resolves, if you had one.
Health Line
2 hours ago
- Health Line
Why Is My Poop So Big It Clogs the Toilet?
You might pass a large stool after eating a big meal. But if it occurs with other symptoms, such as pain or going a few days without pooping, the cause may be another health condition. We've all been there: Sometimes you pass a poop that's so large, you're not sure if you should be calling your doctor or receive a gold medal in pooping. A large poop can be caused by a large meal or just because. It could also mean you need to improve your digestive health. Keep reading for our guide on how to tell when a large poop is cause for concern. When it's an emergency Some poop-related symptoms can require urgent medical attention. This can include: black, tarry stools blood in your stool severe pain when passing stools persistent vomiting What exactly IS a large poop? Poop comes from the digested food material you eat, and it can come in all shapes, sizes, and colors. Most of the time, having one or two episodes of an abnormally shaped or unusually colored poop is not a cause for concern. However, there may be times when you or even a little one in your household make an abnormally large poop. Some of the characteristics of a large poop include poop that's: so large it clogs your toilet so large it fills up most of the toilet bowl resembles large, hard marbles perhaps initially difficult to pass, then it seems to keep coming Sometimes, you have to consider the average size of your poop and compare it to whether the poops you're making have become significantly larger. Average size of poop Believe it or not, there's a visual scale called the Bristol Stool Form Scale that provides images of different types of poop appearances that are all within the normal range. What the scale tells us is that some people poop in pieces while others poop in larger, longer amounts. Neither is wrong. Most poops are several inches in size because this is the amount that fills and stretches the rectum, indicating to you that you need to poop. The 'ideal' poop resembles corn on the cob or sausage, as these are usually softer and easier to pass. Why is my poop so big? Sometimes, your poop is so big because you ate a larger meal. If you had plenty of fiber and water (which both increase the rate at which stool travels in your intestine), the stool exits your body sooner and in a larger quantity. Other times, having a large poop can be cause for concern. Some examples of these times include: Constipation: Constipation occurs when you have poops that are difficult to pass or you don't pass stool very often (usually three times or less a week). This can result in very large and hard-to-pass stools. Megacolon: People who experience chronic constipation or who have a history of bowel obstruction can develop a condition called megacolon, also known as toxic megacolon. This occurs when the colon (large intestine) becomes overstretched. The colon will then hold more stool, which may mean a larger poop. It usually also causes pain and abdominal bloating. A megacolon can be a complication of inflammatory bowel disease (IBD) and usually requires urgent medical attention. Encopresis: Encopresis is a condition that may occur in children, especially children who have chronic constipation. A child loses the ability to sense when larger amounts of stool are present in the rectum and ultimately passes a very large bowel movement (often in their underwear) because they don't recognize the stool sensation. These are just some examples of potential underlying causes for large poops. What can I do to reduce the size of my poops? If you find you're consistently making large poops, this could indicate opportunities for changes in your diet and activity. These changes could make your stool easier to pass, which could decrease the likelihood your poop will be abnormally large. Some steps to take include: Increase your intake of fiber-rich foods, such as whole grains, vegetables, and fruits. Fiber adds bulk to stool, making it easier to pass. Try adding a serving or two to your daily diet to see if it improves your poop frequency. The 2020 to 2025 Dietary Guidelines for Americans recommends eating 25 to 34 grams of fiber per day for adult females and males, respectively. Increase your physical activity level through exercises like walking or swimming that can stimulate additional movement in the bowels. Try eating several small meals throughout the day instead of very large meals at one sitting. This can reduce the volume of food that your intestines process at a time and ideally maintain your blood sugar at consistent levels. Drink plenty of water (enough so that your pee is light yellow in color). This can soften your stool and make it easier to pass. Try going to the bathroom at consistent times each day. This may include the morning and night when you get home from work or school. Provide yourself a few anxiety-free moments to go, but try not to sit on the toilet for more than 10 minutes. Straining or struggling to poop can do more harm than good. Always poop when your body tells you that you need to. Holding in stool can increase the incidence of constipation. Refrain from using laxatives (medications that make you poop) unless a doctor specifically tells you to use them. If these tips don't change the size of your bowel movements, you can also talk with your doctor. Should I see a doctor? 'Normal' bowel movement frequency varies from person to person. While a single episode of a large poop usually isn't cause for concern, having specific symptoms related to stool size may mean you should talk with a doctor. Examples of these include: Consistently going three days or longer without having a bowel movement. This can indicate chronic constipation. Experiencing sudden, unexplained urges to poop and pooping a significant amount. This could indicate IBD or a rectal mass affecting the nerve sensations in your intestine. Experiencing significant to severe abdominal pain after making the large poop. This could indicate several gastrointestinal causes. Experiencing unexplained weight loss. This can indicate various conditions affecting the digestive tract. Your doctor will likely ask you about: your usual bowel habits any patterns you may notice for when you have a large poop your diet any medications you may be taking They may recommend further lifestyle changes and prescribe medications to help you go more frequently. Having bowel movements more often reduces the likelihood you'll have an extremely large poop. The general rule that if something concerns you, you should get it checked out applies. Making an appointment with a doctor or gastroenterologist may provide peace of mind.
Health Line
2 hours ago
- Health Line
What Does It Mean If You Have Burning Legs?
A feeling of burning in your legs can happen with exposure to extreme temperatures or another health condition, including some that affect the nerves. You may experience additional symptoms. What causes burning legs? A burning sensation in your legs may have an obvious explanation, like a leg injury or intense exercise. It could also be the result of damage or exposure to extreme heat, cold, or a toxic substance. A burning feeling in your legs can often be accompanied by: paresthesia (tingling) numbness Some reasons for a burning feeling in your legs aren't as obvious and need a doctor's diagnosis. These conditions include: Meralgia paresthetica Meralgia paresthetica occurs when the nerve that provides sensation to the skin on your thigh is compressed. It's also referred to as Bernhardt-Roth syndrome. The condition often presents as a burning pain on the surface of your outer thigh. The outer thigh may also tingle or feel numb. Venous reflux Venous reflux occurs when the veins in the leg aren't properly circulating blood to the heart. It's also referred to as venous insufficiency. If a leg vein fails, the blood can back up, pool, and leak into the leg tissue. This leads to a hot or burning sensation, often accompanied by discoloration and itching. Shingles Shingles is an illness characterized by a painful rash. It's caused when the varicella-zoster virus (VZV) –the virus that causes chicken pox – reactivates in your body. You can prevent shingles by having the 2-dose shingles vaccine (Shingrix). A shingles rash is often described as a burning pain. The rash may affect any part of your body, including your legs. It often affects one side of the body, but it can appear on both sides. Peripheral neuropathy Peripheral neuropathy is a loss of function of the nerves that relay signals from the body to the spinal cord and brain. It's often associated with: diabetes specific vitamin deficiencies (Vit B1, B6, B9, B12, E) alcohol misuse disorder Guillain-Barré syndrome Multiple sclerosis (MS) Symptoms of MS include sensory disturbances that can lead to burning pain as well as numbness and tingling in the legs. These symptoms are often the result of faulty nerve signals due to MS lesions in the spinal cord and brain. What are the treatment options for burning legs? Treatment of burning legs depends on the underlying cause. Meralgia paresthetica Most people can expect a full recovery from meralgia paresthetica with conservative management, such as: lifestyle modification medications physical therapy steroid injections Medications like aspirin, acetaminophen (Tylenol), naproxen (Aleve), or ibuprofen (Advil) can relieve pain. Shop online for acetaminophen, naproxen, or ibuprofen If your pain is severe or symptoms don't respond to these treatment options, your doctor might recommend the following to reduce pain: corticosteroid injections tricyclic antidepressants antiseizure medications, such as gabapentin (Neurontin), amitriptyline, or pregabalin (Lyrica) Surgery to decompress the nerve might be recommended if your pain is very severe and persistent, but this is rare. Venous reflux Your doctor may recommend the following when venous reflux is diagnosed early: Wear compression stockings: Compression stockings put pressure on your legs to help move blood. Get moving: Avoid standing or sitting for long periods to reduce pressure on your legs. Exercise also helps pump blood. Take blood thinners: Blood thinners can prevent the formation of blood clots. If the condition has progressed, your doctor might recommend a procedure to close a problem vein. Doing so forces blood to flow through healthier veins. These procedures include: Sclerotherapy: Your doctor injects a scarring solution to close the affected vein. Endovenous thermal ablation: A laser or high-frequency radio waves are focused on the problem vein and close it. Ligation: Your doctor cuts and ties off the affected vein. Shingles If you have shingles, it's important to seek treatment within the first 3 days. Getting treatment early may help prevent long term complications of shingles like chronic nerve pain called postherpetic neuralgia (PHN). The treatment for shingles mainly involves managing symptoms and includes medications like: antivirals anti-inflammatories pain relievers (narcotics) anticonvulsants tricyclic antidepressants antihistamines numbing creams, gels, or patches capsaicin (Zostrix) to prevent postherpetic neuralgia (nerve pain) Peripheral neuropathy Treatments for peripheral neuropathy can include: Pain relief: Over-the-counter pain medications, such as nonsteroidal anti-inflammatory drugs, can ease mild symptoms. Stronger painkillers might be prescribed for more severe symptoms. Antiseizure medications: Developed to treat epilepsy, antiseizure medications such as gabapentin (Neurontin) and pregabalin (Lyrica) may relieve nerve pain. Topical treatments: If you're looking for a natural option, capsaicin cream may relieve your symptoms. Lidocaine patches: These patches are applied to the skin and may offer pain relief. If your case of peripheral neuropathy is more serious, your doctor may recommend the following treatments: Transcutaneous electrical nerve stimulation: Electrodes are placed on the skin to deliver a gentle electric current to relieve symptoms. Physical therapy: Exercises can strengthen muscles and improve movements. Acupuncture: Acupuncture uses thin needles pressed through the skin to stimulate healing. Multiple sclerosis There's no cure for MS yet, but treatment can manage symptoms in most cases. Treatment focuses on slowing MS progression and minimizing recovery time following flare-ups. Medications to treat MS include: alemtuzumab (Lemtrada) dimethyl fumarate (Tecfidera) fingolimod (Gilenya) glatiramer acetate (Copaxone) natalizumab (Tysabri) ocrelizumab (Ocrevus) teriflunomide (Aubagio) When to get help Call 911 or your local emergency services if a burning sensation in your leg suddenly appears and is accompanied by: weakness or numbness on one side of your body headache a change in your level of consciousness These can be signs that you're experiencing a stroke. It's vital to seek immediate medical attention for a good outcome and quicker recovery. Takeaway If you have burning leg pain, it may mean you have one of several medical conditions. It's essential to diagnose the condition you have, so you can get effective treatment. The most common causes of burning legs, includes: meralgia paresthetica venous reflux shingles peripheral neuropathy multiple sclerosis
