Comorbidities, Socioeconomic Status, and Colorectal Cancer Diagnostic Route

Area of Science:

• Oncology
• Public Health
• Epidemiology

Background:

• Reducing emergency cancer diagnoses is crucial for improving patient outcomes.
• Preexisting chronic conditions may affect cancer screening participation and diagnosis routes, but evidence is limited, especially in Southern Europe.

Purpose of the Study:

• To analyze how comorbidity status and socioeconomic factors influence colorectal cancer (CRC) diagnosis routes (screening vs. emergency presentation).
• To investigate the association between patient characteristics, diagnostic pathway, and CRC-related short-term mortality.

Main Methods:

• A population-based cohort study utilized linked cancer registry and administrative health data in Italy (2014-2020).
• Analysis included 14,457 CRC cases, examining comorbidity status, socioeconomic factors, diagnostic routes, and short-term mortality using multivariable logistic regression.

Main Results:

• Over one-third of colon cancer cases were diagnosed via emergency presentation.
• Patients with three or more comorbidities had lower odds of screening detection and higher odds of emergency diagnosis.
• Emergency presentation was linked to significantly higher 30-day and 1-year mortality rates. The COVID-19 period saw increased emergency diagnoses.

Conclusions:

• Patients with multiple comorbidities face barriers to screening and are more prone to emergency cancer diagnoses.
• Tailored interventions are essential to enhance screening participation and reduce emergency diagnoses for vulnerable populations.
• Improving diagnostic pathways for patients with chronic conditions can lead to better CRC outcomes.