» Go to news main

Initial presentation of lung cancer in the Emergency Department: a descriptive analysis

Posted by Dr. Daria Manos, Dr. Jennifer Payne & Candice Crocker on February 25, 2019 in Chest
Lung cancer
Lung cancer

See full publication



Guidelines aimed at improving care for lung cancer, the leading cause of cancer-related death in Canada and worldwide, require accurate knowledge of the diagnostic setting or pathway. We sought to determine how often lung cancer is initially diagnosed through the emergency department.


We performed a descriptive study that included all cases of primary lung cancer diagnosed in residents of Nova Scotia in 2014. Cancer registry data included diagnostic data and date of death to Aug. 31, 2016. We reviewed linked hospital records, including laboratory and imaging results, to identify the first positive diagnostic study and the route of presentation (emergency department v. other). We evaluated time from diagnosis to death as a function of presentation route using Kaplan–Meier curves and Cox regression (hazard rate ratios [HRRs]).


Sufficient data were available for 946 of 951 cases identified, of which 336 (35.5%) were diagnosed through the emergency department. Cases diagnosed via the emergency department were more likely to be at an advanced stage (stage IV, 59.5% v. 43.4%), with patients experiencing shorter survival (1-yr survival, 28.4% v. 49.5%), including stage-specific survival. Mortality for cases diagnosed in the emergency department was 54% higher than for the non–emergency department group after adjusting for age and stage (HRR 1.54, 95% confidence interval 1.32–1.81). Few patients (7.1%, n = 24) who presented to the emergency department reported having no family physician.


All comments require a name and email address. You may also choose to log-in using your preferred social network or register with Disqus, the software we use for our commenting system. Join the conversation, but keep it clean, stay on the topic and be brief. Read comments policy.

comments powered by Disqus