title: Cancer diagnosed in the Emergency Department of a Regional Health Service.
abstract: OBJECTIVE
  Patients diagnosed with cancer in the Emergency Department (ED) have more advanced disease at diagnosis and poorer outcomes. High rates of initial presentation to ED suggest potential problems with access to care. The aim of this project was to interpret findings in regional/rural Victoria and explore implications for practice.
  
  
  METHODS
  Cross-sectional study linking two independent data sets.
  
  
  METHODS
  Regional city of Geelong and surrounding rural areas in south-west Victoria.
  
  
  METHODS
  All newly diagnosed cancer patients in 2009.
  
  
  METHODS
  Number of cancer patients diagnosed in the ED.
  
  
  RESULTS
  One in five newly diagnosed cancer patients present to ED 6 months prior to cancer diagnosis. One in 10 is diagnosed as a result of their ED visit. Patients presenting to ED were older, more often men and from disadvantaged areas. Symptoms on presentation included chest complaints, bowel obstruction, abdominal pain, anaemia and generalised weakness. Cancer diagnosed in the ED is associated with advanced stage and shorter survival.
  
  
  CONCLUSIONS
  Reasons for presentation to ED would be multifactorial and include complex cases with coexisting symptoms making diagnosis difficult. The general public appear to have a low level of awareness of alternative primary care services or difficulty accessing such information. Some of the changes towards reducing the number of patients presenting to ED will include patient education.
authors.affiliation: Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia.|School of Medicine, Deakin University, Geelong, Victoria, Australia.
authors.forename: Margaret J
authors.initials: MJ
authors.lastname: Rogers
authors.affiliation: Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia.
authors.forename: Leigh M
authors.initials: LM
authors.lastname: Matheson
authors.affiliation: Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia.
authors.forename: Brooke
authors.initials: B
authors.lastname: Garrard
authors.affiliation: Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia.|School of Medicine, Deakin University, Geelong, Victoria, Australia.|Andrew Love Cancer Centre, Barwon Health, Geelong, Victoria, Australia.
authors.forename: Violet
authors.initials: V
authors.lastname: Mukaro
authors.affiliation: Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia.
authors.forename: Sue
authors.initials: S
authors.lastname: Riches
authors.affiliation: Emergency Department, Barwon Health, Geelong, Victoria, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Sheridan
authors.affiliation: Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia.|School of Medicine, Deakin University, Geelong, Victoria, Australia.|Andrew Love Cancer Centre, Barwon Health, Geelong, Victoria, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Ashley
authors.affiliation: Barwon South Western Regional Integrated Cancer Services, Barwon Health, Geelong, Victoria, Australia.|Andrew Love Cancer Centre, Barwon Health, Geelong, Victoria, Australia.
authors.forename: Graham
authors.initials: G
authors.lastname: Pitson
mesh_terms: D000368:Aged; D016208:Databases, Factual; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D014739:Victoria / Q000453:epidemiology
keywords: Emergency Department; cancer; diagnosis; socio-economically disadvantaged; symptoms