ArticleBritish journal of cancer2017
Does emergency presentation of cancer represent poor performance in primary care? Insights from a novel analysis of linked primary and secondary care data.
Article in British journal of cancer, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed.
- Article
- Article
- Missed opportunities for earlier cancer diagnosis within specific pathways to emergency presentation.Future oncology (London, England) · 2025Article
- Patients' perceptions on reasons for self-referring to the emergency department shortly before a cancer diagnosis: a qualitative study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Analysis of Risk Factors, Treatment Patterns, and Survival Outcomes After Emergency Presentation With Colorectal Cancer: A Prospective Multicenter Cohort Study in Nigeria.Journal of surgical oncology · 2025Article
- Routes to diagnosis for hepatocellular carcinoma patients: predictors and associations with treatment and mortality.British journal of cancer · 2024Article
- Transforming post pandemic cancer services.British journal of cancer · 2024Review
- Diagnosis of cancer in the Emergency Department: A scoping review.Cancer medicine · 2023Article
- Worsened outcomes of newly diagnosed cancer in patients with recent emergency care visits: A retrospective cohort study of 3699 adults in a safety net health system.Cancer medicine · 2023Article
- Prehospital care for ovarian cancer in Catalonia: could we do better in primary care? Retrospective cohort study.BMJ open · 2022Article
- Morbidity and measures of the diagnostic process in primary care for patients subsequently diagnosed with cancer.Family practice · 2022Article
- Recognizing the emergency department's role in oncologic care: a review of the literature on unplanned acute care.Emergency cancer care · 2022Review
- Does geodemographic segmentation explain differences in route of cancer diagnosis above and beyond person-level sociodemographic variables?Journal of public health (Oxford, England) · 2021Article
- Trends in time to cancer diagnosis around the period of changing national guidance on referral of symptomatic patients: A serial cross-sectional study using UK electronic healthcare records from 2006-17.Cancer epidemiology · 2020Article
- Diagnostic and health service pathways to diagnosis of cancer-registry notified cancer of unknown primary site (CUP).PloS one · 2020Article
- Cancer diagnoses after emergency GP referral or A&E attendance in England: determinants and time trends in Routes to Diagnosis data, 2006-2015.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019Article
- Establishing population-based surveillance of diagnostic timeliness using linked cancer registry and administrative data for patients with colorectal and lung cancer.Cancer epidemiology · 2019Article
- Article
- The burden of cancer on primary and secondary health care services before and after cancer diagnosis in New South Wales, Australia.BMC health services research · 2019Article
- Opportunities for reducing emergency diagnoses of colon cancer in women and men: A data-linkage study on pre-diagnostic symptomatic presentations and benign diagnoses.European journal of cancer care · 2019Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPeople diagnosed with cancer following emergency presentation have poorer short-term survival. To what extent this signifies a missed opportunity for earlier diagnosis in primary care remains unclear as little detailed data exist on the patient/general practitioner interaction beforehand.
methodsAnalysis of primary care and regional data for 1802 cancer patients from Northeast Scotland. Adjusted odds ratios (OR) and 95% confidence intervals (CIs) for patient and GP practice predictors of emergency presentation. Qualitative context coding of primary care interaction before emergency presentation.
resultsEmergency presentations equalled 20% (n=365). Twenty-eight per cent had no relevant prior GP contact. Of those with prior GP contact 30% were admitted while waiting to be seen in secondary care, and 19% were missed opportunities for earlier diagnosis. Associated predictors: no prior GP contact (OR=3.89; CI 95% 2.14-7.09); having lung (OR=23.24; 95% CI 7.92-68.21), colorectal (OR=18.49; CI 95% 6.60-51.82) and upper GI cancer (OR=18.97; CI 95% 6.08-59.23); ethnicity (OR=2.78; CI 95% 1.27-6.06).
conclusionsOur novel approach has revealed that emergency cancer presentation is more complex than previously thought. Patient delay, prolonged referral pathways and missed opportunities by GPs all contribute, but emergency presentation can also represent effective care. Resources should be used proportionately to raise public and GP awareness and improve post-referral pathways.
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