This medical records review compared 129 ED-diagnosed cancer cases to 129 randomly selected community-diagnosed cases seen by medical oncology at The Ottawa Hospital (Jan–Mar 2024), evaluating patient characteristics, cancer stage, and diagnostic and treatment intervals.
ED-diagnosed cancers were more often stage IV (65.1% vs 17.3%) with higher one-year mortality (38.8% vs 7.0%). Diagnostic intervals were 4× shorter via the ED (19 vs 84 days), driven by faster imaging and biopsy access; treatment intervals were also shorter (21 vs 55 days). Over 80% of ED-diagnosed patients already had a primary care provider.
- Single tertiary-care centre over 3 months limits generalizability. - Retrospective chart review relied on patient recall for symptom onset dates. - Primary care records were inaccessible, and the study cannot distinguish whether advanced stage at ED diagnosis reflects outpatient delays or rapidly progressive disease.
Most ED cancer diagnoses stem from acute symptoms or accelerated workup—not lack of a primary care provider—so expanding rapid-access community imaging and dedicated cancer diagnostic pathways (not just primary care attachment) is the key lever to close the 4× diagnostic gap.
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