11 percent of cancers detected via emergency visit

About 11 percent of cancers are diagnosed following an emergency department visit, according to a study presented at the 12th AACR Conference on The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved, held from Sept. 20 to 23 in San Francisco.

Caroline A. Thompson, Ph.D., M.P.H., from San Diego State University, and colleagues studied 415,395 Medicare beneficiaries with histologically confirmed first malignant invasive tumors of the breast, colon and rectum, lung, and prostate between 2004 and 2013. Patients with a least one emergency department claim in the month preceding diagnosis were defined as emergency department-mediated.

The researchers found that 11 percent of cancer diagnoses were emergency department-mediated, including 5, 13, 15, and 6 percent of breast, colorectal, lung, and prostate cancers, respectively. Patients with emergency department-mediated cancer diagnoses were more likely to be unmarried (odds ratio, 1.32), be Hispanic or black (odds ratios, 1.47 and 1.41, respectively), have three or more comorbidities (odds ratio, 3.08), and be in the lowest income quartile (odds ratio, 1.26). Among patients with no usual source of care, income was more strongly associated with emergent presentation in stratified analyses.

"Cancer care episodes that begin in the emergency department are likely to be more resource-intensive and more costly than episodes that start in the primary care setting," Thompson said in a statement. "Reducing emergency presentation of cancer patients may improve patient outcomes and health care system efficiency."

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