Patterns of colorectal cancer care for individuals with dementia

Project Reference Number – 0056

Plain language summary - Dementia is a serious disorder which changes the way the brain works, thus affecting day to day living. As the population ages, a growing number of people are at risk of both cancer and dementia. This study aims to investigate how people with dementia are currently diagnosed with colorectal cancer and how that cancer is surgically managed in England. 

People with dementia who are diagnosed with colorectal cancer tend to be diagnosed at a later stage, following emergency presentation, and are less likely to have potentially curative treatment.  Outcomes such as late stage disease, lower rates of active treatment, emergency surgery and early mortality are all known to be more common following an emergency diagnosis of colorectal cancer. The study will investigate, at a population level, whether emergency diagnosis of colorectal cancer in people with a pre-existing dementia diagnosis further worsens outcomes.  It will investigate patterns of care, including routes to diagnosis, in individuals with dementia and a colorectal cancer diagnosis.  It will aim to describe those at greatest risk and identify areas for possible intervention.    With an ageing population leading to a larger number of people at risk of both cancer and dementia, this is a key area of interest when seeking to improve outcomes from cancer. 

The study is a retrospective observational study using population-based data from 2009-2018.  

Dementia status will be determined using data from both inpatient hospital admission and attendance at outpatient clinics, recorded in the six years prior to colorectal cancer diagnosis.  Any under capture will be addressed by comparing these figures with reported dementia incidence in the population as a whole.