Aim: This research examines the characteristics and survival outcomes of patients receiving a lung cancer diagnosis after attending the emergency department (ED) of Waikato hospitals in New Zealand.
Methods: This retrospective study was based on a comprehensive database of Waikato patients recorded on the Midland Lung Cancer Register from 2011 to 2021. We compared the characteristics of patients with and without emergency presentations within 14 days before their lung cancer diagnosis. The survival of patients with and without ED attendance was compared between Māori and non-Māori. This study also analysed the odds ratios (OR) of presenting via ED before diagnosis and surviving 12 months based on logistic regressions.
Results: In total, 2,397 patients were included, with 39.6% attending the ED prior to diagnosis. Māori were 1.27 times more likely than non-Māori to be diagnosed after attending the ED. Other characteristics of patients included being male, being diagnosed with small cell lung cancer and having more advanced-stage disease. Patients attending the ED were less likely to survive 12 months than those without ED visits (OR 0.42), and those with two or more ED visits were even less likely to survive 12 months (OR 0.33).
Conclusion: Patients presenting through the ED have more advanced-stage disease, while those presenting through their general practitioners (GPs) have evidence of being diagnosed earlier and having better survival. Barriers to early diagnoses through attendance with a GP, particularly for Māori and for men, need to be explored.
© PMA.