{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:48:59Z","timestamp":1791251339422,"version":"4.1.0"},"reference-count":35,"publisher":"Royal College of General Practitioners","issue":"659","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Gen Pract"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Emergency diagnosis of cancer is common and aetiologically complex. The proportion of emergency presenters who have consulted previously with relevant symptoms is uncertain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To examine how many patients with cancer, who were diagnosed as emergencies, have had previous primary care consultations with relevant symptoms; and among those, to examine how many had multiple consultations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>Secondary analysis of patient survey data from the 2010 English Cancer Patient Experience Survey (CPES), previously linked to population-based data on diagnostic route.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>For emergency presenters with 18 different cancers, associations were examined for two outcomes (prior GP consultation status; and \u2018three or more consultations\u2019 among prior consultees) using logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 4647 emergency presenters, 1349 (29%) reported no prior consultations, being more common in males (32% versus 25% in females, <jats:italic>P<\/jats:italic>&lt;0.001), older (44% in \u226585 versus 30% in 65\u201374-year-olds, <jats:italic>P<\/jats:italic>&lt;0.001), and the most deprived (35% versus 25% least deprived, <jats:italic>P<\/jats:italic> = 0.001) patients; and highest\/lowest for patients with brain cancer (46%) and mesothelioma (13%), respectively (<jats:italic>P<\/jats:italic>&lt;0.001 for overall variation by cancer site). Among 3298 emergency presenters with prior consultations, 1356 (41%) had three or more consultations, which were more likely in females (<jats:italic>P<\/jats:italic>&lt;0.001), younger (<jats:italic>P<\/jats:italic>&lt;0.001), and non-white patients (<jats:italic>P<\/jats:italic> = 0.017) and those with multiple myeloma, and least likely for patients with leukaemia (<jats:italic>P<\/jats:italic>&lt;0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Contrary to suggestions that emergency presentations represent missed diagnoses, about one-third of emergency presenters (particularly those in older and more deprived groups) have no prior GP consultations. Furthermore, only about one-third report multiple (three or more) consultations, which are more likely in \u2018harder-to-suspect\u2019 groups.<\/jats:p><\/jats:sec>","DOI":"10.3399\/bjgp17x690869","type":"journal-article","created":{"date-parts":[[2017,4,25]],"date-time":"2017-04-25T01:10:37Z","timestamp":1493082637000},"page":"e377-e387","source":"Crossref","is-referenced-by-count":75,"title":["Emergency diagnosis of cancer and previous general practice consultations: insights from linked patient survey data"],"prefix":"10.3399","volume":"67","author":[{"given":"Gary A","family":"Abel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia C","family":"Mendonca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"McPhail","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Elliss-Brookes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Lyratzopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1987","published-online":{"date-parts":[[2017,4,24]]},"reference":[{"key":"2021111110551658000_67.659.e377.1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2012.408"},{"key":"2021111110551658000_67.659.e377.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2013.04.004"},{"key":"2021111110551658000_67.659.e377.3","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1186\/1471-2407-14-927","article-title":"Missed opportunities: racial and neighborhood socioeconomic disparities in emergency colorectal cancer diagnosis and surgery","volume":"14","author":"Pruitt","year":"2014","journal-title":"BMC Cancer"},{"key":"2021111110551658000_67.659.e377.4","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2015.52"},{"key":"2021111110551658000_67.659.e377.5","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2013.569"},{"key":"2021111110551658000_67.659.e377.6","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6114"},{"key":"2021111110551658000_67.659.e377.7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2008.01613.x"},{"key":"2021111110551658000_67.659.e377.8","unstructured":"Quality Health 2014 National Cancer Patient Experience Survey National Report and Related Data, https:\/\/www.quality-health.co.uk\/resources\/surveys\/national-cancer-experience-survey\/2014-national-cancer-patient-experience-survey\/2014-national-cancer-patient-experience-survey-national-reports (accessed 20 Mar 2017)."},{"issue":"8","key":"2021111110551658000_67.659.e377.9","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.2217\/fon.14.80","article-title":"Are emergency diagnoses of cancer avoidable? 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