Core Concepts
The increasing incidence of cancer diagnoses in Canadian emergency departments poses significant challenges in delivering life-altering news to patients in a chaotic environment, highlighting the need for improved healthcare system support and streamlined diagnostic pathways.
Abstract
The content discusses the growing trend of cancer diagnoses being made in Canadian emergency departments (EDs), which is becoming "routine" due to factors such as population growth, aging, and challenges in the healthcare system.
Key highlights:
- Clinicians report a perceived increase in the proportion of patients being diagnosed with cancer in the ED, though definitive data is lacking.
- ED physicians often face difficulties in providing a definitive cancer diagnosis, arranging follow-up tests and referrals, and managing the physical and psychological impact on patients.
- Challenges are exacerbated in rural and remote areas, where access to diagnostic tests and specialist care is limited.
- The primary care system's inability to provide timely access and support for cancer diagnosis is a significant driver of patients seeking care in the ED.
- Potential solutions include implementing single-entry referral models for suspected cancer cases and increasing capacity for early cancer diagnosis in primary care and hospitals.
- Addressing the broader healthcare system issues, such as lack of resources, hospital bed shortages, and physician training, is crucial to improving the management of cancer diagnoses in the ED.
Stats
"We do not yet have data to say that diagnosis of cancer in the ED is becoming more common. However, anecdotally, it seems as though we are seeing this more and more."
"I have essentially diagnosed every form of cancer you can think of at some point in patients in the ED."
"We've all made cancer diagnoses in the ED many times."
Quotes
"These diagnoses are being delivered at a time when EDs across Canada are facing overcrowding and long waits, with patients routinely being seen in hallways and waiting rooms. This chaotic environment makes it a difficult place to deliver this potentially life-altering news to patients with a suspected cancer diagnosis."
"It's one thing to deal with the emotional aspect of breaking bad news. It's another thing if it's complicated by a frustrating, intellectually challenging decision about what to do with and for this person, in terms of their next step."
"With primary care falling apart around us, there are more and more people with less and less access to healthcare, and so these disease processes evolve further before people seek care. By the time they seek care, they come to the ED, and they're really quite ill. But an advanced cancer is not something we're really set up to manage."