Colorectal Cancer: Blacks More Likely to Undergo Emergency Surgery, in 23%

Emergency surgery associated with incomplete oncologic evaluation, and increased incidence of postoperative complications, including mortality

Black patients are more likely to undergo emergency surgery for colorectal cancer, which is associated with worse short- and long-term outcomes, according to a study recently published in the Annals of Surgery.

Ryan Howard, M.D., from the University of Michigan in Ann Arbor, and colleagues used data from 4,869 patients who underwent resection for colorectal cancer between Jan. 1, 2015, and April 30, 2021, to assess the frequency of emergency surgery and identify associated factors.

The researchers found that 23 percent of patients underwent emergency surgery. Black non-Hispanic race was independently associated with a 5.8 percentage point higher risk of emergency surgery than patients of non-Hispanic White race.

Carcinoembryonic antigen measurement, staging for rectal cancer, and wound/ostomy consultation was significantly less likely among patients who underwent emergency surgery.

Further, patients who underwent emergency surgery had a higher incidence of 30-day mortality (5.5 versus 1.0 percent), positive surgical margins (11.1 versus 4.9 percent), complications (29.2 versus 16.0 percent), readmissions (12.5 versus 9.6 percent), and reoperations (12.2 versus 8.2 percent).

Colorectal cancer is universally screened for and develops fairly slowly. So if someone is plugged into the health care system, the chances are very high that we will detect it, and they will get the appropriate evaluation and work-up,” Howard said in a statement.

“The fact that we found patients who are not getting that suggests that there is an opportunity to improve the care we deliver to patients, even before they get to the surgical episode.”

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