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Updated: Jul 16, 2026
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Failure to screen: predictors and burden of emergency colorectal cancer resection
Jessica C Diggs1, Fang Xu, Mireya Diaz
1Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106-4945, USA.
Objective:
To evaluate predictors and burden of emergency colorectal cancer resection (E-CCR).
Study Design:
Cross-sectional study of 127,975 discharges of patients with colorectal cancer undergoing resection.
Methods:
We used the 2002 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project; E-CCR was identified based on the presence of bowel perforation, peritonitis, or obstruction. Bivariate and multilevel multivariable analyses were used to study the association between E-CCR and patient attributes, including demographics, insurance status, comorbidities, health status, and teaching hospital status.
Results:
Among younger patients, Medicaid enrollees (adjusted odds ratio [AOR], 2.08; 95% confidence interval [CI], 1.68-2.58) and the uninsured [AOR], 2.62; 95% CI, 2.05-3.34) were at higher risk for E-CCR. Among older patients, those dually eligible for Medicare and Medicaid were at higher risk for E-CCR (AOR, 1.37; 95% CI, 1.11-1.70). Emergency colorectal cancer resection was associated with greater than 3-fold increased in-hospital mortality, 54 979 (95% CI, 38 731-71 226) excess hospital days as a result of longer lengths of stay, and more than 250 million dollars (95% CI, 180 million-334 million dollars) in hospital charges.
Conclusion:
Targeted interventions to increase colorectal cancer screening in vulnerable subgroups of the population would reduce the substantial patient and societal burden associated with failure to screen.
