The effect of emergency presentation on surgery and survival in lung cancer patients in England, 2006–2008

Abstract

The reduced access to surgical resection and lower survival among lung cancer patients who present through an emergency admission, highlights the importance of ensuring symptoms are recognised early so that presentation as an emergency can be reduced.

Initial presentation of lung cancer in the emergency department: a descriptive analysis

“…Additional research from the UK has found lower survival for patients who present through the emergency department. 22,23 Barriers in access to primary care have been suggested to drive a higher proportion of nonemergent cases to the emergency department. 4 Although there was a higher percentage of "orphaned" patients in the emergency department route to diagnosis, compared with the non-emergency department route, the percentage in both groups was relatively small.…”

“…24 More in-depth research has shown that patients who initially present to the emergency department and are later found to have lung cancer are often selfreferred; socioeconomic deprivation and potential financial, geographic, cultural or information barriers are postulated as contributing factors. 4,22 The nonspecific nature of lung cancer symptoms, in addition to psychosocial factors such as patient guilt associated with smoking [6][7][8][9]22,25 have also been suggested as reasons for delays in seeking care. In turn, these nonspecific symptoms may be less likely to prompt expedient assessment and referral by family physicians.…”

Obesity surgery and risk of colorectal and other obesity-related cancers: An English population-based cohort study

“…Methodological strengths of this study include the population-based cohort design, which reduced selection bias and the large size of the cohort. Another significant strength of this study is the high completeness and validity of the linked HES and NCRAS datasets used in previous studies [ [29] , [30] , [31] , [32] , [33] ]. Studies using these data have shown that the final linked dataset is stronger and richer than its component parts (cancer registration and hospital admissions) with robust recording of cancer incidence [ [34] , [35] ].…”

The Care and Outcomes of Older Persons with Lung Cancer in England and the United States, 2008–2012

“…We observed a lower rate of diagnosis of stage I disease in England than in the United States. Policies targeting early detection and diagnosis are imperative, as 44 deaths for every 1000 patients could be avoided at 32,33 has demonstrated that for approximately 40% of patients lung with cancer, diagnosis is first made as part of an emergency hospital admission. The rate of emergency presentation is higher in older patients, and the 1-year survival rate is significantly lower in those whose disease is diagnosed at emergency presentation across all ages than in those whose disease is diagnosed by other routes.…”

“…The rate of emergency presentation is higher in older patients, and the 1-year survival rate is significantly lower in those whose disease is diagnosed at emergency presentation across all ages than in those whose disease is diagnosed by other routes. 33 Stage distribution is a particularly important public health concern in lung cancer, given the recent evidence that computed tomography-based screening can decrease lung cancer mortality. 34,35 The dissemination of screening into clinical practice has occurred within the last 5 years in some countries, including in the United States.…”