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Emergency Diagnosis of Cancer

 

Tools / Useful Documents/Webinars and Training Links

West Midlands Cancer Alliance    MUO/CUP Pathway  - Policy and Guidelines for the Investigation, Diagnosis and Management of Patients with Malignancy of an Unknown Origin (MUO) and Cancer of an Unknown Primary (CUP).

On-demand webinar supported by Cancer of Unknown Primary Foundation - Jo's Friends: developed for professionals working across the MUO/CUP multi-disciplinary team. Take one hour out to delve into innovative patient referral and management ideas.   Management of MUO/CUP Patients - SBK Healthcare 

Speaker - Dr Sarah Ngan, Consultant in Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust, AOS and CUP service lead, and London Cancer Alliance Pathway Chair for CUPEnhancing referral and management of MUO/CUP 

  1. Assess ways to make the CUP diagnostic and treatment pathway work best for clinicians and patients
  2. Learn from experiences of active CUP clinical trials 
  3. Explore the impact of Covid-19 and the work-arounds to manage CUP patient treatment 
 

 

Articles and Papers
Integration of a patient-centred MUO/CUP service within a new acute oncology service: challenges and rewards

Background Holistic approach to the clinical management pathway for malignancy of undefined primary origin (MUO) / carcinoma of unknown primary (CUP) patients remains an unmet clinical need. To address this, an MUO/CUP service was implemented during conception of a new acute oncology service (AOS).

Conclusion Timely specialised input from AOS with a dedicated MUO/CUP team can achieve enhanced patient-centred and healthcare-centred outcomes, both in terms of survival and hospital stay. However, heterogeneity in both retrospective and prospective study groups, as well as discrepancies in coding, makes direct comparison between both groups challenging.

Sonali Dasgupta, Wendy B Hyland, Conn Haughey, Sohail Mughal, Adam Henry and Celia Diver-Hall.   DOI: https://doi.org/10.7861/fhj.2020-0044  Future Healthc J November 2020
Cancer diagnoses after emergency GP referral or A&E attendance in England: determinants and time trends in Routes to Diagnosis data, 2006–2015

Background Diagnosis of cancer as an emergency is associated with poor outcomes but has a complex aetiology. Examining determinants and time trends in diagnostic routes can help to appreciate the critical role of general practice over time in diagnostic pathways for patients with cancer.

Aim To examine sociodemographic, cancer site, and temporal associations with type of presentation among patients with cancer diagnosed as emergencies.

Annie Herbert, Gary A Abel, Sam Winters, Sean McPhail, Lucy Elliss-Brookes and Georgios Lyratzopoulos- British Journal of General Practice 2019;  69 (687): e724-e730. DOI: https://doi.org/10.3399/bjgp19X705473 
Emergency diagnosis of cancer and previous general practice consultations: insights from linked patient survey data

Background Emergency diagnosis of cancer is common and aetiologically complex. The proportion of emergency presenters who have consulted previously with relevant symptoms is uncertain.

Aim 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.

Gary A Abel, Silvia C Mendonca, Sean McPhail, Yin Zhou, Lucy Elliss-Brookes and Georgios Lyratzopoulos- British Journal of General Practice 2017;  67 (659): e377-e387. DOI: https://doi.org/10.3399/bjgp17X690869 

Emergency presentation of cancer and short-term mortality

Background:The short-term survival following a cancer diagnosis in England is lower than that in comparable countries, with the difference in excess mortality primarily occurring in the months immediately after diagnosis. We assess the impact of emergency presentation (EP) on the excess mortality in England over the course of the year following diagnosis.

Conclusion:Individuals who present as an emergency experience high short-term mortality in all cancer types examined compared with non-EPs. This is partly a case-mix effect but EP remains predictive of short-term mortality even when age, stage, and co-morbidity are accounted for.

McPhail, S., Elliss-Brookes, L., Shelton, J. et al. . Br J Cancer 109, 2027–2034 (2013). https://doi.org/10.1038/bjc.2013.569
 
 

 

 

 

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