Emergency Department Visits Before Cancer Diagnosis Among Women at Mayo Clinic.

Objective: To determine associations of incident cancer diagnoses in women with recent emergency department (ED) care.
Patients and Methods: A retrospective cohort study analyzing biological females aged 18 years and older, who were diagnosed with an incident primary cancer (12 cancer types studied) from January 1, 2015, to December 31, 2021, from electronic health records. The primary outcome was a cancer diagnosis within 6 months of a preceding ED visit. Secondary outcomes included patient factors associated with a preceding ED visit.
Results: Of 25,736 patients (median age of 62 years, range 18-101) diagnosed with an incident primary cancer, 1938 (7.5%) had an ED visit ≤6 months before a diagnosis. The ED-associated cancer cases were highest in lung cancer (n=514, 14.7%) followed by acute lymphoblastic leukemia (n=22, 13.3%). Patient factors increasing the likelihood of ED evaluation before diagnosis included 18-50 years of age (OR=1.32; 95% CI, 1.09-1.61), Elixhauser score (measure of comorbidities) >4 (OR=17.90; 95% CI, 14.21-22.76), use of Medicaid or other government insurance (OR=2.10; 95% CI, 1.63-2.69), residence within the institutional catchment areas (OR=3.18; 95% CI, 2.78-3.66), non-Hispanic Black race/ethnicity (OR=1.41; 95% CI, 1.04-1.88), and established primary care provider at Mayo Clinic (OR=1.45; 95% CI, 1.28-1.65). The ED visits were more likely in those who died within 6 months of diagnosis (n=327, 37.8%) than those who did not die (n=1611, 6.5%).
Conclusion: Patient characteristics identified in this study offer opportunities to provide cancer risk assessment and health navigation, particularly among individuals with comorbidities and limited health care access.
Competing Interests: Dr Mark E. Sherman has received collaborative research funding supported by Exact Sciences unrelated to this manuscript. This work is supported by the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. Given their role as Editorial Board Member, Dr Aaron Spaulding, had no involvement in the peer-review of this article and has no access to information regarding its peer-review. All other authors report no competing interests.
(© 2024 The Authors.)