Emergency diagnosis of lung cancer: An international problem.

Newsom-Davis, Thomas; Berardi, Rossana; Cassidy, Norah; Coate, Linda; Figueiredo, Ana; Gamerith, Gabriele; Giblin, Gareth; Jakopović, Marko; Leest, Cor van der; Pouessel, Damien; Tiseo, Marcello; Toffart, Anne Claire; Hughes, Cathy

doi:10.1200/jco.2015.33.15_suppl.6536

Cited by 2 publications

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This difference persists at all stages up to 36 months after diagnosis, but is especially striking at earlier time points such as 1 month (95.2 vs 61.1% relative survival for those diagnosed via EP vs electively) and 3 months (79.5 vs 35.8%) [5,15]. Indeed, the risk of dying in the first month post-diagnosis is four-times higher for EP compared with non-EP patients [10]. The higher mortality with EP of lung cancer persists even when taking into account key confounding factors such as age, stage, and histological subtype [14,16].…”

Section: Impact Of Ep On Lung Cancer Survivalmentioning

confidence: 99%

“…Although much of the data regarding EP of lung cancer have originated from the UK, it is an international problem that has been demonstrated in other countries such as New Zealand and the USA [7,9]. Proportions in Europe range from 13% (The Netherlands) to 35% (Portugal) [10]. Encouragingly, in England there has been a reduction in the frequency of EP of lung cancer over the past decade, from 39% in 2006 to 34% in 2013 [11,12].…”

Section: Incidence Of Epmentioning

confidence: 99%

“…Certain subtypes of thoracic malignancies, including small-cell lung cancer and mesothelioma, are overrepresented in lung cancer patients presenting via the emergency route [10].…”

Section: Cancer Characteristicsmentioning

confidence: 99%

“…EP patients are less likely to have active treatment for their lung cancer, and less like to undergo surgery or other treatments with curative intent [10]. This remains the case even when confounding factors such as age, socioeconomic status and tumor stage are taken into account [18].…”

Section: Impact Of Ep On Patients and Their Managementmentioning

confidence: 99%

“…This remains the case even when confounding factors such as age, socioeconomic status and tumor stage are taken into account [18]. Reflecting this picture, the diagnosis of lung cancer via the emergency route is more likely to be made on the basis of radiological findings [10,21].…”

Section: Impact Of Ep On Patients and Their Managementmentioning

confidence: 99%

See 4 more Smart Citations

The Route to Diagnosis: Emergency Presentation of Lung Cancer

Newsom-Davis

2017

Lung Cancer Manag.

Self Cite

View full text Add to dashboard Cite

r Emergency presentation (EP) of cancer can be defined as the diagnosis of a new cancer as part of attending an emergency service such as Accident and Emergency, the Emergency Department or an Acute Medical Unit. r EP is common in lung cancer, affecting up to 40% of new diagnoses, and is a feature of healthcare in all countries. r EP of lung cancer is associated with specific patient demographics, such as older age and more co-morbidities, and certain disease characteristics including more advanced stage of disease. r Patients diagnosed via the emergency route are less like to receive anticancer therapy, and have a worse prognosis -especially 1 year survival -than those diagnosed through elective routes. r The emergency route to diagnosis may be unavoidable, and indeed the best option, for some patients. In that situation, prompt input from specialist lung cancer medical and nursing teams is essential. r The causes of EP of lung cancer are complex, and finding solutions is challenging. r Reducing EP of lung cancer may be achieved through development of streamlined diagnostic pathways, public health campaigns, provision of decision-support tools for general practitioners, better communication between primary and secondary care, and improved access to diagnostic oncology services. r Screening for lung cancer may have a positive effect on EP of lung cancer in the future.Asignificant proportion of lung cancer patients are first diagnosed as part of an emergency presentation (EP) to acute medical services. This route to diagnosis is a strong negative predictor of survival, and is associated with age, deprivation and medical co-morbidities. Patients are less likely to receive anticancer treatment than those diagnosed through elective routes. The causes of EP of cancer are complex. When it is unavoidable, prompt input from specialist lung cancer services is needed. Preventing EP of lung cancer involves streamlined diagnostic pathways, public health campaigns about symptoms, decision-support tools for general practitioners, improved communication and access for primary and secondary care, and focus on vague symptoms. Reducing EP of lung cancer is important when improving outcomes and patient experience.

show abstract

Section: Impact Of Ep On Lung Cancer Survivalmentioning

confidence: 99%

Section: Incidence Of Epmentioning

confidence: 99%

“…Certain subtypes of thoracic malignancies, including small-cell lung cancer and mesothelioma, are overrepresented in lung cancer patients presenting via the emergency route [10].…”

Section: Cancer Characteristicsmentioning

confidence: 99%

Section: Impact Of Ep On Patients and Their Managementmentioning

confidence: 99%

Section: Impact Of Ep On Patients and Their Managementmentioning

confidence: 99%

See 3 more Smart Citations

The Route to Diagnosis: Emergency Presentation of Lung Cancer

Newsom-Davis

2017

Lung Cancer Manag.

Self Cite

View full text Add to dashboard Cite

show abstract

Diagnosis of cancer as an emergency: a critical review of current evidence

et al. 2016

View full text Add to dashboard Cite

Many patients with cancer are diagnosed through an emergency presentation, which is associated with inferior clinical and patient-reported outcomes compared with those of patients who are diagnosed electively or through screening. Reducing the proportion of patients with cancer who are diagnosed as emergencies is, therefore, desirable; however, the optimal means of achieving this aim are uncertain owing to the involvement of different tumour, patient and health-care factors, often in combination. Most relevant evidence relates to patients with colorectal or lung cancer in a few economically developed countries, and defines emergency presentations contextually (that is, whether patients presented to emergency health-care services and/or received emergency treatment shortly before their diagnosis) as opposed to clinically (whether patients presented with life-threatening manifestations of their cancer). Consistent inequalities in the risk of emergency presentations by patient characteristics and cancer type have been described, but limited evidence is available on whether, and how, such presentations can be prevented. Evidence on patients' symptoms and health-care use before presentation as an emergency is sparse. In this Review, we describe the extent, causes and implications of a diagnosis of cancer following an emergency presentation, and provide recommendations for public health and health-care interventions, and research efforts aimed at addressing this under-researched aspect of cancer diagnosis.

show abstract

Emergency diagnosis of lung cancer: An international problem.

Cited by 2 publications

References 0 publications

The Route to Diagnosis: Emergency Presentation of Lung Cancer

The Route to Diagnosis: Emergency Presentation of Lung Cancer

Diagnosis of cancer as an emergency: a critical review of current evidence

Contact Info

Product

Resources

About