scholarly journals Diagnosis Setting and Colorectal Cancer Outcomes: The Impact of Cancer Diagnosis in the Emergency Department

2020 ◽  
Vol 255 ◽  
pp. 164-171
Author(s):  
David Weithorn ◽  
Vanessa Arientyl ◽  
Ian Solsky ◽  
Goyal Umadat ◽  
Rebecca Levine ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Emergency Department ◽  
Cancer Diagnosis ◽  
Cancer Outcomes ◽  
The Impact

scholarly journals A Systematic Comparison of Microsimulation Models of Colorectal Cancer

2011 ◽  
Vol 31 (4) ◽  
pp. 530-539 ◽  
Author(s):  
Karen M. Kuntz ◽  
Iris Lansdorp-Vogelaar ◽  
Carolyn M. Rutter ◽  
Amy B. Knudsen ◽  
Marjolein van Ballegooijen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Diagnosis ◽  
Cancer Incidence ◽  
Dwell Time ◽  
Model Parameters ◽  
Underlying Condition ◽  
Deep Model ◽  
The Mean ◽  
Microsimulation Models ◽  
The Impact

Background. As the complexity of microsimulation models increases, concerns about model transparency are heightened. Methods. The authors conducted model “experiments” to explore the impact of variations in “deep” model parameters using 3 colorectal cancer (CRC) models. All natural history models were calibrated to match observed data on adenoma prevalence and cancer incidence but varied in their underlying specification of the adenocarcinoma process. The authors projected CRC incidence among individuals with an underlying adenoma or preclinical cancer v. those without any underlying condition and examined the impact of removing adenomas. They calculated the percentage of simulated CRC cases arising from adenomas that developed within 10 or 20 years prior to cancer diagnosis and estimated dwell time—defined as the time from the development of an adenoma to symptom-detected cancer in the absence of screening among individuals with a CRC diagnosis. Results. The 20-year CRC incidence among 55-year-old individuals with an adenoma or preclinical cancer was 7 to 75 times greater than in the condition-free group. The removal of all adenomas among the subgroup with an underlying adenoma or cancer resulted in a reduction of 30% to 89% in cumulative incidence. Among CRCs diagnosed at age 65 years, the proportion arising from adenomas formed within 10 years ranged between 4% and 67%. The mean dwell time varied from 10.6 to 25.8 years. Conclusions. Models that all match observed data on adenoma prevalence and cancer incidence can produce quite different dwell times and very different answers with respect to the effectiveness of interventions. When conducting applied analyses to inform policy, using multiple models provides a sensitivity analysis on key (unobserved) “deep” model parameters and can provide guidance about specific areas in need of additional research and validation.

Outpatient Palliative Care and Aggressiveness of End-of-Life Care in Patients with Metastatic Colorectal Cancer

2017 ◽  
Vol 35 (1) ◽  
pp. 166-172 ◽  
Author(s):  
Si Won Lee ◽  
Hyun Jung Jho ◽  
Ji Yeon Baek ◽  
Eun Kyung Shim ◽  
Hyun Mi Kim ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Emergency Department ◽  
Palliative Care ◽  
Metastatic Colorectal Cancer ◽  
End Of Life ◽  
End Of Life Care ◽  
Hospice Care ◽  
Emergency Department Visits ◽  
Life Care ◽  
The Impact

Background: Palliative care in outpatient setting has been shown to promote better symptom management and transition to hospice care among patients with advanced cancer. Nevertheless, specialized palliative care is rarely provided at cancer centers in Korea. Herein, we aimed to assess aggressiveness of end-of-life care for patients with metastatic colorectal cancer according to the use of outpatient palliative care (OPC) at a single cancer center in Korea. Methods: We performed a retrospective medical record review for 132 patients with metastatic colorectal cancer who died between 2011 and 2014. Fifty patients used OPC (OPC group), while 82 patients did not (non-OPC group). Indicators of aggressiveness of end-of-life care including chemotherapy use, emergency department visits, hospitalization, and utilization of hospice care were analyzed according to the use of OPC. Results: More patients in the OPC group were admitted to hospice than those in the non-OPC group (32% vs 17%, P = .047). The mean of inpatient days within 30 days of death was shorter for the OPC group than the non-OPC group (4.02 days vs 7.77 days, respectively, P = .032). There were no differences in the proportions of patients who received chemotherapy and visited the emergency department within 30 days from death. Conclusion: Among patients with metastatic colorectal cancer, OPC was associated with shorter inpatient days near death and greater hospice utilization. Further prospective studies are needed to evaluate the impact of OPC on end-of-life care in Korea.

The Impact of Racial Residential Segregation on Colorectal Cancer Outcomes and Treatment

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Michael Poulson ◽  
Ella Cornell ◽  
Andrea Madiedo ◽  
Kelly Kenzik ◽  
Lisa Allee ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Residential Segregation ◽  
Cancer Outcomes ◽  
Racial Residential Segregation ◽  
The Impact

scholarly journals 633Poorly controlled diabetes is a predictor of colorectal cancer survival

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Ming Li ◽  
David Roder
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Cancer Survival ◽  
Epidemiological Studies ◽  
Colorectal Cancer Survival ◽  
Increased Risk ◽  
History Of ◽  
Colorectal Cancer Patients ◽  
The Impact

Abstract Background Epidemiological studies have shown diabetes associated with increased risk of colorectal cancer. This study investigates the impact of a pre-cancer diabetes-related hospitalization record on colorectal cancer survival. Methods A retrospective cohort of 13190 colorectal cancer patients recorded on the South Australian Cancer Registry in 2003-2013 were examined. Diabetes-related hospitalization histories were obtained using linked inpatient data. Colorectal cancer deaths were available for 2003-2013. The association of survival from colorectal cancer with diabetes-related hospitalization history was assessed using competing risk analysis, adjusting for sociodemographic factors and cancer stage at diagnosis. Results 2765 patients with colorectal cancer (26.5%) had a history of hospital admission for diabetic complications, the most common being multiple complications (32%), followed by kidney and eye complications. The 5- and 10-year cancer survival probabilities were 63% and 56% in those with a diabetes complication history, significantly lower than 66% and 60% for patients without these complications (adjusted sub hazard ratio 1.11, 95% CI 1.02-1.20). Risk of colorectal cancer death was lower when theses diabetes-related hospitalizations were earlier than the year of cancer diagnosis - i.e., adjusted SHR 0.80, 95% CI 0.66-0.97 for 3-5 and 0.76, 95% CI 0.59-0.98 for 6+ years before the cancer diagnosis compared with same-year hospitalizations. Conclusions Colorectal cancer patients with a history of diabetes-related hospitalization have poorer survival, particularly if these hospitalizations were in the same year as the cancer diagnosis. Key messages Poorly controlled diabetes histories predict increased risk of colorectal cancer mortality.

A pilot study to determine the feasibility of a customized low glycemic load diet in patients with stage I-III colorectal cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4643-4643
Author(s):  
Michelle Elizabeth Treasure ◽  
Alicia Thomas ◽  
Stephen Ganocy ◽  
Augustine Hong ◽  
Smitha S. Krishnamurthi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Pilot Study ◽  
Dietary Intervention ◽  
Dietary Habits ◽  
Glycemic Load ◽  
Stage I ◽  
Cancer Outcomes ◽  
Glycemic Indices ◽  
Metabolic Indices ◽  
The Impact

4643 Background: Observational evidence associates energy balance factors, particularly diet, with survival in patients with colorectal cancer (CRC). Consumption of a diet with high glycemic indices has been associated with inferior cancer-specific outcomes, but there is limited prospective evidence that alterations in dietary habits improve cancer outcomes. This was a pilot study to determine the feasibility and acceptability of following a low glycemic load (GL) diet in patients with stage I-III CRC and to assess the nutritional resources necessary to follow the diet. Methods: 18 patients with stage I-III CRC, who completed definitive cancer therapy and consumed an avg daily GL > 150 participated in a 12 week, tailored, in-person dietary intervention with a target GL of ≤102. Compliance was assessed using 24 hour telephone recalls. Acceptability of the diet was assessed using a food acceptability questionnaire, and exploratory correlative laboratories were assessed monthly. Results: 67% of patients were compliant with a low GL diet ≥ 75% of the time, over a 12 week time period. Majority of participants experienced a decrease in BMI and waist circumference, 28% experienced meaningful weight loss defined as ≥ 5%. The nutritionist spent an avg of 6.97 hours (SD 2.18) in-person and 1.58 hours (SD 0.68) by phone with each participant. In the overall group, significant decreases were seen in total cholesterol (7.2% decrease; t = -2.33, p = 0.03), VLDL (26.8% decrease; t = -2.33, p = 0.03) and triglycerides (26.6% decrease; t = -2.29; p = 0.04). All participants were satisfied with the diet; 43% were extremely satisfied. 75% of participants liked the foods they were able to eat “very much” or “extremely”. All participants felt the in-person meetings were helpful. 77% did not feel an online video could replace the in-person meetings. 62% of participants did not feel a virtual meeting (e.g skype, etc.) could replace the in- person meeting while 38% felt it could. Conclusions: Patients with stage I-III CRC are able to follow a low GL diet with an in-person dietary intervention. Significant decreases in laboratory measures confirm the efficacy of the diet in altering metabolic indices. All participants who completed the study were satisfied with the diet, the majority of whom enjoyed the foods and planned to continue to follow the diet after study completion. The majority felt in-person contact with the nutritionist was essential to their success. This study was an essential step in designing a larger scale trial to evaluate the impact of low GL diet on cancer outcomes. Clinical trial information: NCT02129218 .

508 THE IMPACT OF RESIDENTIAL SEGREGATION ON COLORECTAL CANCER DIAGNOSIS AND TREATMENT

2020 ◽  
Vol 158 (6) ◽  
pp. S-1514
Author(s):  
Michael Poulson ◽  
Andrea M. Madiedo ◽  
Tracey Dechert ◽  
Jason Hall
Keyword(s):  
Colorectal Cancer ◽  
Residential Segregation ◽  
Cancer Diagnosis ◽  
Diagnosis And Treatment ◽  
The Impact

Impact of Body Mass Index on Survival After Colorectal Cancer Diagnosis: The Cancer Prevention Study-II Nutrition Cohort

2012 ◽  
Vol 30 (1) ◽  
pp. 42-52 ◽  
Author(s):  
Peter T. Campbell ◽  
Christina C. Newton ◽  
Ahmed N. Dehal ◽  
Eric J. Jacobs ◽  
Alpa V. Patel ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Body Mass Index ◽  
Cancer Prevention ◽  
Body Mass ◽  
Cancer Diagnosis ◽  
Prevention Study ◽  
Risk Of Mortality ◽  
Incident Cancer ◽  
The Impact

Purpose The impact of body mass index (BMI) on survival after colorectal cancer diagnosis is poorly understood. This study assessed the association of pre- and postdiagnosis BMI with all-cause and cause-specific survival among men and women diagnosed with colorectal cancer in a prospective cohort. Patients and Methods Participants in the Cancer Prevention Study-II Nutrition Cohort reported weight and other risk factor information via a self-administered questionnaire at baseline in 1992 to 1993. Updated information on current weight and incident cancer was reported via periodic follow-up questionnaires. This analysis includes 2,303 cohort participants who were diagnosed with nonmetastatic colorectal cancer between baseline and mid 2007 and were observed for mortality from diagnosis through December 2008. Results A total of 851 participants with colorectal cancer died during the 16-year follow-up period, including 380 as a result of colorectal cancer and 153 as a result of cardiovascular disease (CVD). In analyses of prediagnosis BMI (weight reported at baseline in 1992 to 1993; mean, 7 years before colorectal cancer diagnosis), obese BMI (≥ 30 kg/m2) relative to normal BMI (18.5 to 24.9 kg/m2) was associated with higher risk of mortality resulting from all causes (relative risk [RR], 1.30; 95% CI, 1.06 to 1.58), colorectal cancer (RR, 1.35; 95% CI, 1.01 to 1.80), and CVD (RR, 1.68; 95% CI, 1.07 to 2.65). Postdiagnosis BMI (based on weight reported; mean, 1.5 years after diagnosis) was not associated with all-cause or cause-specific mortality. Conclusion This study suggests that prediagnosis BMI, but not postdiagnosis BMI, is an important predictor of survival among patients with nonmetastatic colorectal cancer.

The impact of the COVID ‐19 pandemic on colorectal cancer diagnosis and management; A Binational Colorectal Cancer Audit study

2021 ◽  
Author(s):  
Evan Williams ◽  
Joseph C. Kong ◽  
Parry Singh ◽  
Swetha Prabhakaran ◽  
Satish K. Warrier ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Diagnosis ◽  
Diagnosis And Management ◽  
The Impact

Polypharmacy in elders with cancer: An analysis of the Ohio medicaid population

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19550-19550
Author(s):  
S. M. Koroukian ◽  
C. Owusu ◽  
E. Madigan ◽  
M. Diaz
Keyword(s):  
Colorectal Cancer ◽  
Cancer Diagnosis ◽  
The Elderly ◽  
Time Frame ◽  
Cancer Site ◽  
Narcotic Analgesics ◽  
Study Population ◽  
Medicaid Beneficiaries ◽  
Potassium Replacement ◽  
The Impact

19550 Background: Polypharmacy in the elderly complicates therapy, increases cost of treatment and is a challenge to healthcare agencies. However, the impact of polypharmacy on the care of the older cancer patient has been poorly described. The objective of this study was to characterize the use of pharmacy drugs in the month preceding cancer diagnosis among Ohio Medicaid beneficiaries 65 years of age or older, and diagnosed with incident breast, prostate, or colorectal cancer during the study period 1997–2001. Methods: Medicaid beneficiaries were identified by linking data from the Ohio Cancer Incidence Surveillance System (OCISS) with Medicaid enrollment and claims files on a year-by-year basis. Because of potentially incomplete claims history, the study was limited to patients who were enrolled in Medicaid continuously in the year preceding initial cancer diagnosis. Additionally, those with spenddown or nursing home stay in that time frame were excluded from the analysis. Demographics, anatomic cancer site and stage were retrieved from the OCISS, and all non-pharmacy claims for services received in the year prior to cancer diagnosis were accounted for in deriving the Charlson comorbidity score. Results: The study population included 652 patients: 282 with incident breast cancer, 111 with prostate cancer, and 259 with colorectal cancer. The median age was 73, 74, and 75 years among breast, prostate, and colorectal cancer patients, respectively. Nearly 45% were prescribed at least one type of medication in the month preceding cancer diagnosis. Of those with any prescription in that time period, nearly 49% were prescribed 5 or more types of medications. The most commonly prescribed types of medication were narcotic analgesics, diuretics and potassium replacement, anti- hypertensive agents, laxatives, antianxiety drugs, and antidpressants. No significant variations in the use of medications were observed across the different subgroups of the study population. Conclusions: Polpypharmacy (5 or more types of medication) was present in more than 22% of patients in this study population. The effects of polpypharmacy above and beyond that of comorbidities, disability, and other geriatric syndromes, relative to cancer-related outcomes should be determined. No significant financial relationships to disclose.

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