{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T22:33:02Z","timestamp":1793226782697,"version":"4.5.0"},"reference-count":37,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5R38CA245095"],"award-info":[{"award-number":["5R38CA245095"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007059","name":"Northwestern University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007059","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","surgjournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Surgery"],"published-print":{"date-parts":[[2026,11]]},"DOI":"10.1016\/j.surg.2026.110457","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:01:15Z","timestamp":1784246475000},"page":"110457","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Characterizing prior symptomatic emergency department visits among patients undergoing unplanned colon cancer surgery"],"prefix":"10.1016","volume":"199","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0791-4193","authenticated-orcid":false,"given":"Joanna T.","family":"Buchheit","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2982-7616","authenticated-orcid":false,"given":"Conor T.","family":"Broderick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Shan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Sanchez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casey M.","family":"Silver","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy L.","family":"Halverson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alona","family":"Furmanchuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Lundberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8334-0304","authenticated-orcid":false,"given":"Anne M.","family":"Stey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.surg.2026.110457_bib1","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/s13017-018-0192-3","article-title":"2017 WSES guidelines on colon and rectal cancer emergencies: obstruction and perforation","volume":"13","author":"Pisano","year":"2018","journal-title":"World J Emerg Surg"},{"key":"10.1016\/j.surg.2026.110457_bib2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s13017-023-00474-y","article-title":"Who should operate patients presenting with emergent colon cancer? A comparison of short- and long-term outcome depending on surgical sub-specialization","volume":"18","author":"Arnarson","year":"2023","journal-title":"World J Emerg Surg"},{"key":"10.1016\/j.surg.2026.110457_bib3","doi-asserted-by":"crossref","first-page":"2077","DOI":"10.1007\/s00268-008-9632-7","article-title":"Population-based information on emergency colorectal surgery and evaluation on effect of operative volume on mortality","volume":"32","author":"Kwan","year":"2008","journal-title":"World J Surg"},{"key":"10.1016\/j.surg.2026.110457_bib4","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1377\/hlthaff.2021.01615","article-title":"Social vulnerability and outcomes for access-sensitive surgical conditions among medicare beneficiaries","volume":"41","author":"Zhang","year":"2022","journal-title":"Health Aff"},{"key":"10.1016\/j.surg.2026.110457_bib5","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1007\/s10147-019-01497-9","article-title":"Outcomes of non-metastatic colon cancer patients in relationship to socioeconomic status: an analysis of SEER census tract-level socioeconomic database","volume":"24","author":"Abdel-Rahman","year":"2019","journal-title":"Int J Clin Oncol"},{"key":"10.1016\/j.surg.2026.110457_bib6","doi-asserted-by":"crossref","DOI":"10.1001\/jamasurg.2022.7055","article-title":"Patient and hospital characteristics associated with delayed diagnosis of appendicitis","volume":"158","author":"Reyes","year":"2023","journal-title":"JAMA Surg"},{"key":"10.1016\/j.surg.2026.110457_bib7","first-page":"99","article-title":"Editorial: helping health care organizations to define diagnostic errors as missed opportunities in diagnosis","volume":"40","author":"Singh","year":"2014","journal-title":"Jt Comm J Qual Patient Saf"},{"key":"10.1016\/j.surg.2026.110457_bib8","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1016\/j.annepidem.2017.10.006","article-title":"Examining racial disparities in colon cancer clinical delay in the colon cancer patterns of care in Chicago study","volume":"27","author":"Jones","year":"2017","journal-title":"Ann Epidemiol"},{"key":"10.1016\/j.surg.2026.110457_bib9","doi-asserted-by":"crossref","DOI":"10.1155\/2015\/285096","article-title":"Missed opportunities for the diagnosis of colorectal cancer","volume":"2015","author":"Siminoff","year":"2015","journal-title":"Biomed Res Int"},{"key":"10.1016\/j.surg.2026.110457_bib10","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1097\/DCR.0000000000001068","article-title":"Disparities in colon cancer survival by insurance type: a population-based analysis","volume":"61","author":"Pulte","year":"2018","journal-title":"Dis Colon Rectum"},{"key":"10.1016\/j.surg.2026.110457_bib11","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2024.1319977","article-title":"Urban vs rural: colorectal cancer survival and prognostic disparities from 2000 to 2019","volume":"12","author":"Fu","year":"2024","journal-title":"Front Public Health"},{"key":"10.1016\/j.surg.2026.110457_bib12","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/bs.acr.2021.02.007","article-title":"Racial and ethnic disparities in colorectal cancer incidence and mortality","volume":"151","author":"Carethers","year":"2021","journal-title":"Adv Cancer Res"},{"key":"10.1016\/j.surg.2026.110457_bib13","doi-asserted-by":"crossref","first-page":"1742","DOI":"10.1093\/ije\/dyz117","article-title":"Data resource profile: state inpatient databases","volume":"48","author":"Metcalfe","year":"2019","journal-title":"Int J Epidemiol"},{"key":"10.1016\/j.surg.2026.110457_bib15","doi-asserted-by":"crossref","first-page":"1850","DOI":"10.4251\/wjgo.v13.i12.1850","article-title":"Management of obstructive colon cancer: current status, obstacles, and future directions","volume":"13","author":"Yoo","year":"2021","journal-title":"World J Gastrointest Oncol"},{"key":"10.1016\/j.surg.2026.110457_bib16","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1097\/MLR.0b013e31819432e5","article-title":"A modification of the Elixhauser comorbidity measures into a point system for hospital death using administrative data","volume":"47","author":"van Walraven","year":"2009","journal-title":"Med Care"},{"key":"10.1016\/j.surg.2026.110457_bib17","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s12885-020-6526-z","article-title":"Improving management of comorbidity in patients with colorectal cancer using comprehensive medical assessment: a pilot study","volume":"20","author":"Signal","year":"2020","journal-title":"BMC Cancer"},{"key":"10.1016\/j.surg.2026.110457_bib18","doi-asserted-by":"crossref","first-page":"12118","DOI":"10.1002\/cam4.5901","article-title":"Variations in colorectal cancer pattern of care by age and comorbidity in South Australia","volume":"12","author":"Gheybi","year":"2023","journal-title":"Cancer Med"},{"key":"10.1016\/j.surg.2026.110457_bib19","first-page":"542","article-title":"Health insurance status and cancer stage at diagnosis and survival in the United States","volume":"72","author":"Zhao","year":"2022","journal-title":"CA Cancer J Clin"},{"key":"10.1016\/j.surg.2026.110457_bib20","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1007\/s00268-002-6678-9","article-title":"Delay in treatment of colorectal cancer: multifactorial problem","volume":"27","author":"Langenbach","year":"2003","journal-title":"World J Surg"},{"key":"10.1016\/j.surg.2026.110457_bib21","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1016\/j.ejso.2017.04.014","article-title":"Association between the time to surgery and survival among patients with colon cancer: a population-based study","volume":"43","author":"Flemming","year":"2017","journal-title":"Eur J Surg Oncol (EJSO)"},{"key":"10.1016\/j.surg.2026.110457_bib22","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1155\/2010\/692151","article-title":"Wait times from presentation to treatment for colorectal cancer: a population-based study","volume":"24","author":"Singh","year":"2010","journal-title":"Can J Gastroenterol"},{"key":"10.1016\/j.surg.2026.110457_bib23","doi-asserted-by":"crossref","DOI":"10.2217\/crc-2020-0012","article-title":"High incidence of prolonged rectal bleeding and advanced stage cancer in early-onset colorectal cancer patients","volume":"9","author":"Sandhu","year":"2020","journal-title":"Colorectal Cancer"},{"key":"10.1016\/j.surg.2026.110457_bib24","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1016\/j.cgh.2016.10.038","article-title":"Advanced-stage colorectal cancer in persons younger than 50 years not associated with longer duration of symptoms or time to diagnosis","volume":"15","author":"Chen","year":"2017","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"suppl 5","key":"10.1016\/j.surg.2026.110457_bib25","article-title":"A delayed path to diagnosis: findings from young-onset colorectal cancer patients and survivors","volume":"39","author":"Newcomer","year":"2021","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.surg.2026.110457_bib26","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.30072","article-title":"Assessment of time-to-treatment initiation and survival in a cohort of patients with common cancers","volume":"3","author":"Cone","year":"2020","journal-title":"JAMA Netw Open"},{"key":"10.1016\/j.surg.2026.110457_bib27","article-title":"Mortality due to cancer treatment delay: systematic review and meta-analysis","volume":"371","author":"Hanna","year":"2020","journal-title":"BMJ"},{"key":"10.1016\/j.surg.2026.110457_bib29","doi-asserted-by":"crossref","first-page":"545","DOI":"10.3390\/jpm12040545","article-title":"LACE index to predict the high risk of 30-day readmission: a systematic review and meta-analysis","volume":"12","author":"Rajaguru","year":"2022","journal-title":"J Pers Med"},{"key":"10.1016\/j.surg.2026.110457_bib30","doi-asserted-by":"crossref","first-page":"3163","DOI":"10.1177\/00031348231160833","article-title":"The intersection of race and rurality and its effect on colorectal cancer survival","volume":"89","author":"Tobin","year":"2023","journal-title":"Am Surg"},{"key":"10.1016\/j.surg.2026.110457_bib31","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.6721","article-title":"Appendicitis hospitalization care costs among patients with delayed diagnosis of appendicitis","volume":"7","author":"Kulasekere","year":"2024","journal-title":"JAMA Netw Open"},{"key":"10.1016\/j.surg.2026.110457_bib32","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1097\/MLR.0000000000000988","article-title":"Racial and ethnic composition of hospitals' service areas and the likelihood of being penalized for excess readmissions by the medicare program","volume":"56","author":"Gaskin","year":"2018","journal-title":"Med Care"},{"key":"10.1016\/j.surg.2026.110457_bib33","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1097\/SLA.0000000000004691","article-title":"County-level social vulnerability is associated with worse surgical outcomes especially among minority patients","volume":"274","author":"Diaz","year":"2021","journal-title":"Ann Surg"},{"key":"10.1016\/j.surg.2026.110457_bib34","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.jtcvs.2023.04.025","article-title":"Disparities in early-stage lung cancer outcomes at minority-serving hospitals compared with nonminority serving hospitals","volume":"167","author":"Deboever","year":"2024","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.surg.2026.110457_bib35","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1097\/DCR.0000000000000967","article-title":"Understanding patients' experiences of diagnosis and treatment of advanced colorectal cancer in a safety-net hospital system: a qualitative study","volume":"61","author":"Leal","year":"2018","journal-title":"Dis Colon Rectum"},{"key":"10.1016\/j.surg.2026.110457_bib36","doi-asserted-by":"crossref","first-page":"2166","DOI":"10.1245\/s10434-021-10232-6","article-title":"Bias issues in colorectal cancer management: a review","volume":"29","author":"Johnston","year":"2022","journal-title":"Ann Surg Oncol"},{"key":"10.1016\/j.surg.2026.110457_bib37","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1200\/JCO.2014.56.8642","article-title":"How do integrated health care systems address racial and ethnic disparities in Colon cancer?","volume":"33","author":"Rhoads","year":"2015","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.surg.2026.110457_bib38","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1007\/s11605-020-04744-x","article-title":"Racial disparities in treatment for rectal cancer at minority-serving hospitals","volume":"25","author":"Lu","year":"2021","journal-title":"J Gastrointest Surg"},{"key":"10.1016\/j.surg.2026.110457_bib39","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1308\/003588406X94904","article-title":"Symptomatic presentation of early colorectal cancer","volume":"88","author":"Smith","year":"2006","journal-title":"Ann R Coll Surg Engl"}],"container-title":["Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S003960602600382X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S003960602600382X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T22:08:30Z","timestamp":1793225310000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S003960602600382X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,11]]},"references-count":37,"alternative-id":["S003960602600382X"],"URL":"https:\/\/doi.org\/10.1016\/j.surg.2026.110457","relation":{},"ISSN":["0039-6060"],"issn-type":[{"value":"0039-6060","type":"print"}],"subject":[],"published":{"date-parts":[[2026,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Characterizing prior symptomatic emergency department visits among patients undergoing unplanned colon cancer surgery","name":"articletitle","label":"Article Title"},{"value":"Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.surg.2026.110457","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"110457"}}