RT Journal Article SR Electronic T1 Emergency diagnosis of cancer and previous general practice consultations: insights from linked patient survey data JF British Journal of General Practice JO Br J Gen Pract FD British Journal of General Practice SP e377 OP e387 DO 10.3399/bjgp17X690869 VO 67 IS 659 A1 Gary A Abel A1 Silvia C Mendonca A1 Sean McPhail A1 Yin Zhou A1 Lucy Elliss-Brookes A1 Georgios Lyratzopoulos YR 2017 UL http://bjgp.org/content/67/659/e377.abstract AB Background Emergency diagnosis of cancer is common and aetiologically complex. The proportion of emergency presenters who have consulted previously with relevant symptoms is uncertain.Aim To examine how many patients with cancer, who were diagnosed as emergencies, have had previous primary care consultations with relevant symptoms; and among those, to examine how many had multiple consultations.Design and setting Secondary analysis of patient survey data from the 2010 English Cancer Patient Experience Survey (CPES), previously linked to population-based data on diagnostic route.Method For emergency presenters with 18 different cancers, associations were examined for two outcomes (prior GP consultation status; and ‘three or more consultations’ among prior consultees) using logistic regression.Results Among 4647 emergency presenters, 1349 (29%) reported no prior consultations, being more common in males (32% versus 25% in females, P<0.001), older (44% in ≥85 versus 30% in 65–74-year-olds, P<0.001), and the most deprived (35% versus 25% least deprived, P = 0.001) patients; and highest/lowest for patients with brain cancer (46%) and mesothelioma (13%), respectively (P<0.001 for overall variation by cancer site). Among 3298 emergency presenters with prior consultations, 1356 (41%) had three or more consultations, which were more likely in females (P<0.001), younger (P<0.001), and non-white patients (P = 0.017) and those with multiple myeloma, and least likely for patients with leukaemia (P<0.001).Conclusion Contrary to suggestions that emergency presentations represent missed diagnoses, about one-third of emergency presenters (particularly those in older and more deprived groups) have no prior GP consultations. Furthermore, only about one-third report multiple (three or more) consultations, which are more likely in ‘harder-to-suspect’ groups.