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Emergency Presentation: a case-control study (EMPRESS)

Study Design:

Observational study

Disease Area:

Cancer / Primary Care


Cancer Research UK NAEDI

Chief Investigator:

Professor Una Macleod, Hull and York Medical School, University of Hull

(Research Manager for Primary Care and Cancer)

Research sponsor:

University of Hull


Research conducted using routinely collected health data shows that around a quarter of patients with cancer are initially diagnosed during an emergency presentation to hospital. This may be through Accident and Emergency, or patients may have been referred as an emergency by their GP or from a hospital clinic. Patients who are diagnosed with cancer in this way have poorer outcomes than patients diagnosed following referral to hospital by their GP through the usual UK fast track system –the two-week-wait pathway. While some of these emergency presentations will occur because of sudden onset of symptoms, we know very little about what happens to patients in the period before they present to hospital as an emergency. We are particularly interested in understanding what contact patients have in primary care in the year before their cancer diagnosis, as this is where we can most likely develop ways of reducing the number of emergency presentations.

This study involves a detailed investigation of the emergency presentation pathway in order to identify and understand the reasons for this type of presentation. In particular we are asking:


  • Are there differences in the pathway to diagnosis between patients who are diagnosed during an emergency presentation compared to those diagnosed through the 2WW referral system?
  • What are the characteristics and primary health care experiences of patients with colorectal and lung cancers who are diagnosed as a result of emergency presentation, compared to those diagnosed through the 2WW referral system?

Trial progress



Hull Health Trials Unit
3rd Floor AMB
University of Hull