1. Risk factors and prognostic implications of diagnosis of cancer within 30 days after an emergency hospital admission (emergency presentation): an International Cancer Benchmarking Partnership (ICBP) population-based study.
- Author
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McPhail, S, Swann, R, Johnson, SA, Barclay, ME, Abd Elkader, H, Alvi, R, Barisic, A, Bucher, O, Clark, GRC, Creighton, N, Danckert, B, Denny, CA, Donnelly, DW, Dowden, JJ, Finn, N, Fox, CR, Fung, S, Gavin, AT, Gomez Navas, E, Habbous, S, Han, J, Huws, DW, Jackson, CGCA, Jensen, H, Kaposhi, B, Kumar, SE, Little, AL, Lu, S, McClure, CA, Møller, B, Musto, G, Nilssen, Y, Saint-Jacques, N, Sarker, S, Te Marvelde, L, Thomas, RS, Thomas, RJS, Thomson, CS, Woods, RR, Zhang, B, Lyratzopoulos, G, ICBP Module 9 Emergency Presentations Working Group, McPhail, S, Swann, R, Johnson, SA, Barclay, ME, Abd Elkader, H, Alvi, R, Barisic, A, Bucher, O, Clark, GRC, Creighton, N, Danckert, B, Denny, CA, Donnelly, DW, Dowden, JJ, Finn, N, Fox, CR, Fung, S, Gavin, AT, Gomez Navas, E, Habbous, S, Han, J, Huws, DW, Jackson, CGCA, Jensen, H, Kaposhi, B, Kumar, SE, Little, AL, Lu, S, McClure, CA, Møller, B, Musto, G, Nilssen, Y, Saint-Jacques, N, Sarker, S, Te Marvelde, L, Thomas, RS, Thomas, RJS, Thomson, CS, Woods, RR, Zhang, B, Lyratzopoulos, G, and ICBP Module 9 Emergency Presentations Working Group
- Abstract
BACKGROUND: Greater understanding of international cancer survival differences is needed. We aimed to identify predictors and consequences of cancer diagnosis through emergency presentation in different international jurisdictions in six high-income countries. METHODS: Using a federated analysis model, in this cross-sectional population-based study, we analysed cancer registration and linked hospital admissions data from 14 jurisdictions in six countries (Australia, Canada, Denmark, New Zealand, Norway, and the UK), including patients with primary diagnosis of invasive oesophageal, stomach, colon, rectal, liver, pancreatic, lung, or ovarian cancer during study periods from Jan 1, 2012, to Dec 31, 2017. Data were collected on cancer site, age group, sex, year of diagnosis, and stage at diagnosis. Emergency presentation was defined as diagnosis of cancer within 30 days after an emergency hospital admission. Using logistic regression, we examined variables associated with emergency presentation and associations between emergency presentation and short-term mortality. We meta-analysed estimates across jurisdictions and explored jurisdiction-level associations between cancer survival and the percentage of patients diagnosed as emergencies. FINDINGS: In 857 068 patients across 14 jurisdictions, considering all of the eight cancer sites together, the percentage of diagnoses through emergency presentation ranged from 24·0% (9165 of 38 212 patients) to 42·5% (12 238 of 28 794 patients). There was consistently large variation in the percentage of emergency presentations by cancer site across jurisdictions. Pancreatic cancer diagnoses had the highest percentage of emergency presentations on average overall (46·1% [30 972 of 67 173 patients]), with the jurisdictional range being 34·1% (1083 of 3172 patients) to 60·4% (1317 of 2182 patients). Rectal cancer had the lowest percentage of emergency presentations on average overall (12·1% [10 051 of 83 325 patients]), with a jurisdic
- Published
- 2022