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

Zhou, Y; Abel, GA; Hamilton, W; Pritchard-Jones, K; Gross, CP; Walter, FM; Renzi, C; ... Lyratzopoulos, G; + view all (2017) Diagnosis of cancer as an emergency: a critical review of current evidence. Nature Reviews Clinical Oncology , 14 (1) pp. 45-56. 10.1038/nrclinonc.2016.155. Green open access

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Abstract

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.

Type: Article
Title: Diagnosis of cancer as an emergency: a critical review of current evidence
Open access status: An open access version is available from UCL Discovery
DOI: 10.1038/nrclinonc.2016.155
Publisher version: http://dx.doi.org/10.1038/nrclinonc.2016.155
Language: English
Additional information: Copyright © 2016 Macmillan Publishers Limited, part of Springer Nature.
Keywords: Cancer screening, Diagnosis, Risk factors
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept
URI: https://discovery.ucl.ac.uk/id/eprint/1521436
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