Abstract: Importance: Cancer diagnosis following an emergency department presentation (unscheduled care) is associated with lower cancer survival and poor patient-reported outcomes. Previous research has suggested considerable heterogeneity in cancer diagnosis patterns across different health jurisdictions. Objective: We studied cancer diagnosis patterns (diagnosis in scheduled versus unscheduled care) in one of the largest administrative regions in the United Kingdom and examined variations across different demographic groups. Methods: The study sample consisted of all new cancer diagnoses in National Health Service (NHS) Greater Glasgow and Clyde (GGC), which serves 1.2 million people, in 2018, 2019 (before pandemic), 2021, and 2022 (after pandemic). The outcome of interest was cancer diagnosis following an emergency department presentation. Logistic regression was used to assess cross-sectional associations between demographic factors, cancer types, and the outcome. Results: Over a four-year period, N = 40,223 individual new cancer diagnoses were recorded; N = 12,940 cases (32.2%) were diagnosed after an emergency presentation, with a trend toward higher rates in 2021–2022 compared to 2018–2019. People living in areas of high socioeconomic deprivation and those with multiple long-term conditions had higher odds of being diagnosed with cancer after an emergency attendance (unscheduled care). Age had a “J-shaped” relationship with the risk of cancer diagnosis following emergency presentation, with the lowest risk observed between 45 and 60 years. Finally, central nervous system, hematological, and pancreatic cancers were consistently more likely to get diagnosed in unscheduled care than other cancer types. Conclusion: Further research on patient- and healthcare organization-related factors that may contribute to cancer diagnoses in unscheduled care is needed so that potentially modifiable factors can be improved.
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