sarcoma patients were alive. Symptoms at EPFor many patients, presenting signs were related to the eventual diagnosis, whereas for others symptoms were either not immediately suggestive of cancer or appeared unrelated to the cancer diagnosed (Table 2). Indeed, with the exception of brain tumours and sarcomas (which appeared to manifest only neurological type signs, and joint pain and swelling, respectively), presenting symptoms involved a range of physiological systems, regardless Adidas Originals Gazelle Og Blue Sneakers
(Ritchie and Spencer, 1994), were used to synthesise findings. Individual SEA documents were read and re read and a coding frame constructed, which was then applied to the data to identify emerging themes. In addition, an Interpretative Matrix was created to better understand the factors related to the diagnostic pathway. Relevant data from each SEA were extracted and incorporated into a thematic chart to allow identification and interpretation of common and diverse aspects of presentation and pathways of care. QSR Nvivo 2. 0 software (Melbourne, VIC Australia) was used to facilitate coding and organisation of data for analysis. Although analysis of SEAs also has the potential to provide quantitative data related to certain aspects of the diagnostic process, we have focussed on eliciting the context surrounding each presentation and have not quantified data except to characterise participants and identify cases of extended primary care input or longer illness timescales for detailed study. Top of pageResultsBackground: Methods: Results: Conclusions: Materials and methods Results Discussion Conflict of interest References Acknowledgements Figures and TablesCharacteristics of casesA total of 222 cases of emergency cancer presentation originating from 203 practices were included in the analysis (65. 6 of those who participated in the initiatives).
Median survival for those patients known to have died and with date of Adidas Gazelle Indigo Blue
death provided (88. 4 was 39 days (range 0 days). The shortest median survival times were found for carcinoid and head and neck Adidas Gazelle Cheapest cancer (0 and 24 days, respectively), and the longest for brain tumours (136 days). All breast cancer, melanoma and Adidas Gazelle Og Navy Pink
Date of diagnosis ranged from 1993 to 2014, with the majority having occurred from 2009 onwards (79. 7 The 1993 diagnosis related to an 18 year old patient with lymphoma and was returned by the practice as part of an SEA initiative looking at the last TYA diagnosis rather than the last EP specifically. It is therefore possible that this was the most recent case in the practice (Box 1). 17. 2), and more than half were reported as being alive at SEA completion (Table 1). However, the proportion of lung cancer patients who present as emergencies is among the highest for any cancer (National Cancer Intelligence Network, 2013). Nine patients (4. 1 had metastatic disease from a cancer of unknown primary (CUP).
of tumour type. This is perhaps an indication of the fact that almost half of the included patients were reported as having advanced or metastatic disease at presentation and therefore present.
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