| Title: |
Emergency cancer diagnosis in older adults: patterns, subgroups, and implications for health-care quality metrics |
| Authors: |
Soppe, Sarah E; Peacock Hinton, Sharon; Dillon, Ellis C; Pruitt, Sandi L; Lyratzopoulos, Georgios; Barclay, Matthew E; Mullins, Megan A; Kurian, Allison W; Pettit, Nicholas; Thompson, Matthew; Thompson, Caroline A |
| Source: |
JNCI Cancer Spectrum, 10(2) |
| Publisher Information: |
Oxford University Press |
| Publication Year: |
2026 |
| Collection: |
Carolina Digital Repository (UNC - University of North Carolina) |
| Subject Terms: |
Diffusion of innovations; sex difference; residential care; Yeast surface display; tumor microenvironment; caregiver burden; community nursing; segmentation; Unicompartmental knee arthroplasty; Agentes terapéuticos; bortezomib; Schistosoma; CAR T cells; Work-life balance; Parasitic skin disease; thematic analysis; Caffeine; urothelial carcinoma; risk assessment methodologies; MRI scan; routinely collected health data; diagnostic delay; point-of-care ultrasound (POCUS); Daidzein; Dengue; COVID-19; long-term care; EC. 3.4.22.25; self-monitoring; Radiologist burnout |
| Description: |
Background Cancer diagnosis originating in emergency departments (emergency presentation) contributes to poorer cancer survival and reflects aggressive disease and limited access to routine health care. This study characterized emergency presentations for a range of cancers and subclassified by whether patients were hospitalized after the emergency encounter, with the hypothesis that, compared with those hospitalized, patients not requiring hospitalization more specifically represent barriers to timely and adequate care. Methods We analyzed Surveillance, Epidemiology, and End Results–Medicare data for patients aged 66 years and older diagnosed with 14 cancer types (2008-2017; n = 614 885). We described emergency presentation overall and demographic and clinical characteristics across subgroups using linear regression and assessed differences in health-care utilization before the emergency presentation classification window. Results In total, 234 606 (38%) patients were classified as emergency presentations, with 187 439 (80%) hospitalized. Emergency presentations were more likely than nonemergency presentations to have prediagnostic emergency care (40%, 95% confidence interval [CI] = 40% to 40%) vs 30% (95% CI = 29% to 30%) and less likely to have nonemergency care for potential cancer symptoms (61%, 95% CI = 61% to 61%, vs 67%, 95% CI = 67% to 67%), with minimal variation between inpatient and outpatient emergency presentations. Compared with inpatient emergency presentations, outpatient emergency presentations were more often younger than 70 years old (24%, 95% CI = 23% to 24%, vs 19%, 95% CI = 19% to 19%), nonmetropolitan residents (25%, 95% CI = 24% to 25%, vs 12%, 95% CI = 12% to 12%), and had localized cancer (25%, 95% CI = 25% to 26%, vs 17%, 95% CI = 17% to 17%). Conclusions More than one-third of older adult US cancer patients with these cancer types are diagnosed through emergency presentation, with most requiring hospitalization. Outpatient emergency presentations are more common among patients in ... |
| Document Type: |
article in journal/newspaper |
| Language: |
unknown |
| Relation: |
https://cdr.lib.unc.edu/downloads/pg15bw96c?file=thumbnail; https://cdr.lib.unc.edu/downloads/pg15bw96c |
| DOI: |
10.17615/dsbz-cm03 |
| Availability: |
https://doi.org/10.17615/dsbz-cm03; https://cdr.lib.unc.edu/downloads/pg15bw96c?file=thumbnail; https://cdr.lib.unc.edu/downloads/pg15bw96c |
| Rights: |
http://rightsstatements.org/vocab/InC/1.0/ ; http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.56DDA529 |
| Database: |
BASE |