A new national study concluded that “more than one in four older adults are diagnosed” with cancer inside an emergency department, and “their chances of surviving the first year are significantly lower.”

Researchers examined “nearly 930,000 Medicare patients diagnosed with one of 16 common cancers between 2008 and 2017. About 28% were diagnosed after an emergency department (ED) visit, known as an emergency presentation.” One year after diagnosis, 81% of patients diagnosed through routine outpatient care were still alive; among patients admitted from the ED, “only 36% were.”

The lead author clarified that these results held up “even after [they] accounted for age, cancer stage, other illnesses, and frailty.” These findings “challenge long-standing assumptions about emergency cancer diagnosis. After “accounting for patients who were older and experiencing more severe comorbidities and more advanced disease, researchers still found that an emergency presentation predicted higher mortality. This pattern also appeared in cancers that are often considered more treatable or commonly detected through screening, including breast, prostate, bladder and blood cancers.”

These findings also highlight that “health systems should monitor how often people are diagnosed with cancer in the emergency room, because it can reveal problems in how quickly cancers are being found. Catching cancer earlier can prevent patients from reaching the point of needing an emergency visit. Targeted efforts to improve public symptom awareness, expand primary care access, and strengthen diagnostic coordination may help decrease cancers diagnosed as emergencies and improve survival.