Key Points Question What are the characteristics of patients with active cancer presenting to US emergency departments? Findings In this multicenter cohort study of 1075 adult patients with active cancer in the Comprehensive Oncologic Emergencies Research Network (CONCERN), patients commonly presented with symptoms such as pain (62.1%) and nausea (31.3%), were frequently treated for potential infection (26.5%), and were admitted (57.2%; 25.0% for <2 days) or placed in observation (7.6%). Meaning Opportunities for improving emergency department care for patients with cancer include establishing protocols and processes for prompt and appropriate symptom control, creating improved risk stratification tools, and improving outpatient management to prevent ED visits.

Background Timeliness of care may contribute to racial disparities in breast cancer mortality. African American women experience greater treatment delay than White women in most, but not all studies. Understanding these disparities is challenging since many studies lack patient-reported data and use administrative data sources that collect limited types of information. We used interview and medical record data from the Carolina Breast Cancer Study (CBCS) to identify determinants of delay and assess whether disparities exist between White and African American women (n=601). Methods The CBCS is a population-based study of North Carolina women. We investigated the association of demographic and socioeconomic characteristics, healthcare access, clinical factors, and measures of emotional and functional well-being with treatment delay. The association of race and selected characteristics with delays of >30 days were assessed using logistic regression. Results Household size, losing a job due to one’s diagnosis, and immediate reconstruction were associated with delay in the overall population and among White women. Immediate reconstruction and treatment type were associated with delay among African American women. Racial disparities in treatment delay were not evident in the overall population. In the adjusted models, African American women experienced greater delay than White women for younger age groups: odds ratio (OR), 3.34; 95% confidence interval (CI), 1.07–10.38 for ages 20–39, and OR, 3.40; 95% CI, 1.76–6.54 for ages 40–49. Conclusions Determinants of treatment delay vary by race. Racial disparities in treatment delay exist among women <50 years old. Impact Specific populations need to be targeted when identifying and addressing determinants of treatment delay.

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Specifications and data collection tools are available for 34 PEACE quality measures that were highly rated by experts in hospice and palliative care. Future research should assess the scientific soundness and responsiveness of these measures to quality improvement.

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