Risk factors for emergency presentation with lung and colorectal cancers: a systematic review

Area of Science:

• Oncology
• Public Health
• Healthcare Services Research

Background:

• Emergency presentation (EP) is a critical pathway for cancer diagnosis.
• Understanding factors influencing EP is crucial for timely diagnosis and improved patient outcomes.
• Existing research has explored various patient and practitioner-related influences on EP.

Purpose of the Study:

• To systematically review and identify patient and practitioner factors associated with cancer diagnosis via emergency presentation.
• To synthesize evidence on demographic, socioeconomic, and clinical factors influencing emergency cancer diagnosis.
• To explore the role of primary care access and utilization in emergency cancer diagnosis.

Main Methods:

• Systematic review of studies published between 1996 and 2014.
• Searches conducted across multiple databases including MEDLINE, EMBASE, and CINAHL.
• Inclusion of studies assessing factors associated with colorectal or lung cancer diagnosis via EP, with no language restrictions.

Main Results:

• Older patient age, female gender (for lung cancer), and higher socioeconomic deprivation were associated with increased EP for lung and colorectal cancers.
• Unmarried status, pain, obstruction, and weight loss were linked to colorectal cancer EP.
• Limited primary care access and utilization were positively associated with EP; practitioner factors showed no conclusive evidence.

Conclusions:

• Patient-related factors significantly influence the likelihood of cancer diagnosis through emergency presentation.
• Cancer symptoms and healthcare-seeking behaviors are key determinants of EP.
• Further research is needed to elucidate the contextual factors influencing these risk factors and help-seeking behaviors.