Impact of critical illness on subsequent cancer care and outcomes, in patients with colorectal cancer

Taylor, Callum George Wilson (2026) Impact of critical illness on subsequent cancer care and outcomes, in patients with colorectal cancer. MD thesis, University of Glasgow.

Abstract

Colorectal cancer (CRC) is the third most common form of cancer in Scotland, with one in six patients with CRC being treated in critical care within two years of their diagnosis, and estimates for overall five‐year survival in Scotland being less than 50%. The impact of critical illness on subsequent CRC care quality and outcomes remains poorly understood. This thesis uses novel linkage of available national datasets to critical care admission records to describe a cohort of >40,000 Scottish patients with CRC, investigating how critical illness impacts adherence to cancer care quality performance indicators (QPIs), receipt and quality of adjuvant systemic anti‐cancer therapy (SACT), and five‐year overall survival. Using a Bayesian statistical framework, this cohort was stratified both by care level (ward level, monitoring in critical care, receipt of organ support) during index admission following diagnosis, and the nature of admission (elective versus emergency). This thesis provides strong evidence that patients who survive critical illness receive poorer subsequent CRC care as measured by the Scottish QPI framework. Critical illness is associated with a meaningful reduction in the likelihood of achieving QPI for timely adjuvant SACT receipt, as well as a meaningful increase in delays commencing adjuvant SACT, that persists when including patients excluded by QPI criteria. For patients treated in critical care, critical illness is likely to have a causal impact on both subsequent adjuvant SACT receipt, and long‐term overall survival. This impact persists among patients who survived their initial critical illness. In identifying the impact of critical illness on long term cancer outcomes, this thesis provides an opportunity for future work to assess critical illness’ impact on other patient centred outcomes, as well as highlighting potentially modifiable factors to improve cancer care quality and long term outcomes.

• Item Type: Thesis (MD)
• Qualification Level: Doctoral
• Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
• Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Supervisor's Name: Puxty, Dr. Kathryn, Shaw, Dr. Martin and Quasim, Professor Tara
• Date of Award: 2026
• Depositing User: Theses Team
• Unique ID: glathesis:2026-86228
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 10 Sep 2026 10:10
• Last Modified: 10 Sep 2026 10:11
• Thesis DOI: 10.5525/gla.thesis.86228
• URI: https://theses.gla.ac.uk/id/eprint/86228

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