{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:49:48Z","timestamp":1791251388449,"version":"4.1.0"},"reference-count":58,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute at the National Institutes of Health","doi-asserted-by":"publisher","award":["R01-CA-264176"],"award-info":[{"award-number":["R01-CA-264176"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Cancer Diagnosis in the Emergency Department: Explaining Persistent Disparities"},{"name":"Cancer Research United Kingdom International Alliance for Cancer Early Detection","award":["EDDAPA-2022\/100002"],"award-info":[{"award-number":["EDDAPA-2022\/100002"]}]},{"name":"Cancer Research United Kingdom","award":["C18081\/A18180"],"award-info":[{"award-number":["C18081\/A18180"]}]},{"name":"Advanced Clinician Scientist Fellowship provided support"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Emergency presentation (EP) for cancer diagnosis is associated with higher mortality, but prior research has focused largely on select cancer types or non-US populations. We estimated EP prevalence and associated mortality across 16 cancers in a national Medicare cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using SEER-Medicare data, we identified patients with 16 high-burden cancers diagnosed from 2008 to 2017. EP was defined by an emergency department (ED) claim within 30\u2009days before the index cancer claim and subtyped as inpatient EP (emergency hospitalization) or outpatient EP (after ED discharge). We estimated survival probabilities and mortality risk ratios (RRs) adjusted for demographics, tumor characteristics, comorbidity, frailty, and health-care utilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 929\u2009378 patients, 28% were EPs (22% inpatient, 6% outpatient). EP prevalence ranged from &amp;lt;10% (breast, prostate) to &amp;gt;40% (liver, lung, stomach, colon, ovarian, pancreatic cancers). One-year survival was 81% for non-EPs, 60% for outpatient EPs, and 36% for inpatient EPs. Compared with non-EPs, inpatient EPs had nearly 4-fold higher 30-day adjusted mortality (RR\u2009=\u20093.88, 95% CI = 3.81 to 3.96), ranging from 2.1 (pancreas) to 6.3 (lymphoma). Among 90-day survivors, inpatient EPs had 51% higher 1-year mortality (RR\u2009=\u20091.51, 95% CI = 1.49 to 1.52), ranging from 1.1 (pancreas) to 2.1 (lymphoma). Outpatient EPs showed intermediate risk (1-year mortality RR\u2009=\u20091.28, 95% CI = 1.26 to 1.30).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>EP is common and predicts persistently elevated mortality in older US adults after comprehensive covariate adjustment. Associations were strongest for cancer types underrepresented in prior research, including hematological malignancies and breast, prostate, and bladder cancers. Routine EP monitoring could improve risk stratification at diagnosis and guide efforts to reduce avoidable emergency presentations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djag236","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T11:37:03Z","timestamp":1784029023000},"source":"Crossref","is-referenced-by-count":1,"title":["Mortality after emergency presentation: evidence from a cohort of 929\u2009378 Medicare beneficiaries with common cancers diagnosed 2008-2017"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9990-9756","authenticated-orcid":false,"given":"Caroline A","family":"Thompson","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina , Chapel Hill, NC,","place":["United States"]},{"name":"Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill , Chapel Hill, NC,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuelin","family":"He","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina , Chapel Hill, NC,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E","family":"Soppe","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina , Chapel Hill, NC,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueer","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina , Chapel Hill, NC,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan A","family":"Mullins","sequence":"additional","affiliation":[{"name":"Department of Health Economics, Systems, and Policy, Peter O\u2019Donnell Jr. School of Public Health, UT Southwestern Medical Center , Dallas, TX,","place":["United States"]},{"name":"Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center , Dallas, TX,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew E","family":"Barclay","sequence":"additional","affiliation":[{"name":"Department of Behavioural Science and Health, Epidemiology of Cancer Healthcare and Outcomes group, Institute of Epidemiology and Health Care, University College London , London,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4457-591X","authenticated-orcid":false,"given":"Nicholas","family":"Pettit","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Indiana University School of Medicine , Indianapolis, IN,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6175-9470","authenticated-orcid":false,"given":"Allison W","family":"Kurian","sequence":"additional","affiliation":[{"name":"Departments of Medicine and of Epidemiology and Population Health, Stanford University School of Medicine , Stanford, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellis C","family":"Dillon","sequence":"additional","affiliation":[{"name":"Center on Aging, University of Connecticut , Farmington, CT,","place":["United States"]},{"name":"Department of Public Health Sciences, University of Connecticut , Farmington, CT,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandi","family":"Pruitt","sequence":"additional","affiliation":[{"name":"Harold C. 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