Analysis of Risk Factors, Treatment Patterns, and Survival Outcomes After Emergency Presentation With Colorectal Cancer: A Prospective Multicenter Cohort Study in Nigeria
Adeniyi S. Aderibigbe
Department of Surgery, Federal Medical Center, Owo, Ondo State, Nigeria
Search for more papers by this authorAnna J. Dare
Department of Surgery, St. Michael's Hospital & University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorHannah L. Kalvin
Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorOlalekan Olasehinde
Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
Search for more papers by this authorFunmilola Wuraola
Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
Search for more papers by this authorAdewale Adisa
Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
Search for more papers by this authorAdeleye Dorcas Omisore
Department of Radiology, College of Health Sciences, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
Search for more papers by this authorAkinwumi O. Komolafe
Department of Morbid Anatomy, College of Health Sciences, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
Search for more papers by this authorOluwatosin Zainab Omoyiola
Department of Morbid Anatomy, College of Health Sciences, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
Search for more papers by this authorChukwuma Eze Okereke
Department of Surgery, Federal Medical Center, Owo, Ondo State, Nigeria
Search for more papers by this authorAba Katung
Department of Surgery, Federal Medical Center, Owo, Ondo State, Nigeria
Search for more papers by this authorAdedeji Egberoungbe
Department of Radiology, Federal Medical Center, Owo, Ondo State, Nigeria
Search for more papers by this authorOlufemi Ariyibi
Department of Morbid Anatomy, Federal Medical Center, Owo, Ondo State, Nigeria
Search for more papers by this authorSamuel Adegboyega Olatoke
Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
Search for more papers by this authorAdemola Adetoyese Adeyeye
Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
Search for more papers by this authorSulaiman Olayide Agodirin
Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
Search for more papers by this authorMatthew Olumuyiwa Bojuwoye
Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
Search for more papers by this authorJames Oluwaleke Fayenuwo
African Research Group for Oncology, Ife, Osun State, Nigeria
Search for more papers by this authorOluwabusayomi Roseline Ademakinwa
African Research Group for Oncology, Ife, Osun State, Nigeria
Search for more papers by this authorDapo Osinowo
Department of Pathology, Lagos University Teaching Hospital, College of Medicine, University of Lagos, Lagos, Nigeria
Search for more papers by this authorAbdul-Razak Lawal
Department of Pathology, Lagos University Teaching Hospital, College of Medicine, University of Lagos, Lagos, Nigeria
Search for more papers by this authorFatimah B. Abdulkareem
Department of Pathology, Lagos University Teaching Hospital, College of Medicine, University of Lagos, Lagos, Nigeria
Search for more papers by this authorDebra Goldman
Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorGregory Knapp
Department of Surgery, Division of General Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
Search for more papers by this authorShilpa Murthy
Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
Search for more papers by this authorRivka Kahn
Global Cancer Disparities Initiative, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Search for more papers by this authorMithat Gonen
Department of Surgery, Federal Medical Center, Owo, Ondo State, Nigeria
Search for more papers by this authorCorresponding Author
T. Peter Kingham
Global Cancer Disparities Initiative, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Correspondence: T. Peter Kingham ([email protected])
Search for more papers by this authorOlusegun I. Alatise
Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
African Research Group for Oncology, Ife, Osun State, Nigeria
Search for more papers by this authorFor the African Research Group in Oncology Colorectal Cancer Working Group
Search for more papers by this authorAdeniyi S. Aderibigbe
Department of Surgery, Federal Medical Center, Owo, Ondo State, Nigeria
Search for more papers by this authorAnna J. Dare
Department of Surgery, St. Michael's Hospital & University of Toronto, Toronto, Ontario, Canada
Search for more papers by this authorHannah L. Kalvin
Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorOlalekan Olasehinde
Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
Search for more papers by this authorFunmilola Wuraola
Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
Search for more papers by this authorAdewale Adisa
Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
Search for more papers by this authorAdeleye Dorcas Omisore
Department of Radiology, College of Health Sciences, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
Search for more papers by this authorAkinwumi O. Komolafe
Department of Morbid Anatomy, College of Health Sciences, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
Search for more papers by this authorOluwatosin Zainab Omoyiola
Department of Morbid Anatomy, College of Health Sciences, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
Search for more papers by this authorChukwuma Eze Okereke
Department of Surgery, Federal Medical Center, Owo, Ondo State, Nigeria
Search for more papers by this authorAba Katung
Department of Surgery, Federal Medical Center, Owo, Ondo State, Nigeria
Search for more papers by this authorAdedeji Egberoungbe
Department of Radiology, Federal Medical Center, Owo, Ondo State, Nigeria
Search for more papers by this authorOlufemi Ariyibi
Department of Morbid Anatomy, Federal Medical Center, Owo, Ondo State, Nigeria
Search for more papers by this authorSamuel Adegboyega Olatoke
Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
Search for more papers by this authorAdemola Adetoyese Adeyeye
Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
Search for more papers by this authorSulaiman Olayide Agodirin
Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
Search for more papers by this authorMatthew Olumuyiwa Bojuwoye
Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
Search for more papers by this authorJames Oluwaleke Fayenuwo
African Research Group for Oncology, Ife, Osun State, Nigeria
Search for more papers by this authorOluwabusayomi Roseline Ademakinwa
African Research Group for Oncology, Ife, Osun State, Nigeria
Search for more papers by this authorDapo Osinowo
Department of Pathology, Lagos University Teaching Hospital, College of Medicine, University of Lagos, Lagos, Nigeria
Search for more papers by this authorAbdul-Razak Lawal
Department of Pathology, Lagos University Teaching Hospital, College of Medicine, University of Lagos, Lagos, Nigeria
Search for more papers by this authorFatimah B. Abdulkareem
Department of Pathology, Lagos University Teaching Hospital, College of Medicine, University of Lagos, Lagos, Nigeria
Search for more papers by this authorDebra Goldman
Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Search for more papers by this authorGregory Knapp
Department of Surgery, Division of General Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
Search for more papers by this authorShilpa Murthy
Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
Search for more papers by this authorRivka Kahn
Global Cancer Disparities Initiative, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Search for more papers by this authorMithat Gonen
Department of Surgery, Federal Medical Center, Owo, Ondo State, Nigeria
Search for more papers by this authorCorresponding Author
T. Peter Kingham
Global Cancer Disparities Initiative, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Correspondence: T. Peter Kingham ([email protected])
Search for more papers by this authorOlusegun I. Alatise
Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
African Research Group for Oncology, Ife, Osun State, Nigeria
Search for more papers by this authorFor the African Research Group in Oncology Colorectal Cancer Working Group
Search for more papers by this authorAdeniyi S. Aderibigbe and Anna J. Dare share first authorship.
ABSTRACT
Background and Objectives
Prospective data on presentation and outcomes of colorectal cancer (CRC) in Nigeria are limited; however, emergency presentation with advanced disease is thought common.
Methods
Consecutive CRC patients presenting at six sites over 6 years were included. Risk factors for emergency presentation were evaluated using logistic regression methods. Overall survival (OS) was compared between emergent and elective patients using Kaplan-Meier methods and the log-rank test.
Results
Of 535 patients, 30.7% presented emergently. Median age was 56 years, 55% were men, and 5.0% reported a cancer family history. Emergency patients had more proximal cancers (42.1% vs. 24.0%), Stage IV disease (61.6% vs. 40.2%; p < 0.001), lower household income (₦35 000/month vs. ₦50 000/month), lower education levels (p = 0.008) and accessed care with nonmotorized transport (50.6% vs. 37.2%; p = 0.005). Median OS was shorter in the emergency group (6.4 vs. 17.4 months; p < 0.001). Across clinical stages, emergency presentation was associated with worse OS (Stage IV median OS 4.8 vs. 9.4 months; p = 0.002). Surgery improved survival in both groups, although emergency patients had higher 30-day postoperative mortality (23.2% vs. 9.1%; p < 0.001).
Conclusions
Emergent Nigerian CRC patients have worse OS than elective patients. Cancer control efforts should focus on faster cancer detection, early presentation, diagnosis, and treatment.
Open Research
Data Availability Statement
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
Supporting Information
| Filename | Description |
|---|---|
| jso27878-sup-0001-CRC_Emergency_Paper_Supplementary_Material_AD4_HK3_06Jun2024_1.docx941.6 KB | Supporting information. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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