In every tumour type examined, 1-year relative survival was significantly lower for Emergency Presentations than for any other route.
The reasons for emergency presentations vary by cancer site and therefore, these studies can have only limited potential to inform clinical practice and management for individual cancer types.
The findings of this study provide support for the hypothesis that traffic-related air pollution is potentially hazardous to children with asthma, and proximity to busy roadways tends to increase the risk for emergency presentations.
Crude proportions and crude and adjusted odds ratios were calculated for emergency presentation, and interactions between sex, age and deprivation with cancer were examined.
Relatedly, it should be noted that 'linear' crude patterns of decreasing risk for emergency presentation in younger age groups disappear after case-mix adjustment (Table 1).
There was very large variation in the crude risk for emergency presentation by cancer, being lowest for melanoma and oral cancer (2% and 5%, respectively) and very high for patients with brain cancer and ALL (67%and79%9%, respectively; Table 1).
Statistically significant interaction terms (P<0.05) were retained in the model (model 2), which was then used to estimate cancer-specific odds ratios for emergency presentation, by sex, age and deprivation.
Compared with men, women were at greater risk for emergency presentation for bladder, brain, rectal, liver, stomach, colon and lung cancer (e.g., bladder cancer-specific odds ratio for women vs men, 1.50; 95% CI 1.39 1.60), whereas the opposite was true for oral/oropharyngeal cancer, lymphomas and melanoma (e.g., oropharyngeal cancer-specific odds ratio for women vs men, 0.49; 95% CI 0.32 0.73).
Similarly, younger patients were at higher risk for emergency presentation for acute leukaemia, colon, stomach and oesophageal cancer (e.g., colon cancer-specific odds ratio in 35 44- vs 65 74-year-olds 65 74-year-olds 65 74-year-oldsder patients for laryngeal, melanoma, thyroid, oral and Hodgkin's lymphoma (e.g., melanoma specific odds ratio in 35–44- vs 65–74-year-olds, 0.2.0195% CI 0.1.76 2.30
A qualitative study of 55 GPs and thematic analysis (Green et al, 2015) and a synthesis of significant event audits to examine the reasons for emergency presentation (Mitchell et al, 2015) offer insights into cancer diagnosis in primary care and possible opportunities for intervention.
