Routes to diagnosis and survival in Danish patients with non–small cell lung cancer: the impact of emergency admission
5 affiliations
- 1Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus N, Denmark.
- 2Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark.
- 3Department of Medicine, Lillebaelt Hospital Vejle, Vejle, Denmark.
- 4Department of Medicine, Odense University Hospital Svendborg, Svendborg, Denmark.
- 5Odense Respiratory Research Unit (ODIN), Department of Clinical Research, University of Southern Denmark, Svendborg, Denmark.
Abstract
Background Worldwide, lung cancer remains the leading cause of cancer-related death. Studies have shown that receiving a lung cancer diagnosis following an unplanned admission is associated with poor prognosis. The causal relationship between emergency presentation and survival remains uncertain.Methods We conducted a population-based retrospective study including a random sample of 1,000 Danish patients diagnosed with non-small cell lung cancer (NSCLC) between 2014 and 2016, identified through the Danish Lung Cancer Registry. Detailed data on route to diagnosis, stage, performance status, comorbidity, and survival were retrieved from electronic health records. Associations between route to diagnosis and survival were examined using logistic regression adjusted for relevant clinical covariates.Results Of 974 eligible patients, 234 (24%) were diagnosed following emergency admission. These patients were more likely to present with advanced stage (stage IV: 70% vs. 43%) and have poorer performance status. One- and five‑year survival were markedly lower in patients admitted acutely (32% and 8%) compared to non-emergency presenters (56% and 22%; p < 0.001). The adjusted odds ratio for 5-year survival following emergency admission was 0.47 (95% CI 0.28–0.81). After adjusting for disease stage, emergency admission was no longer independently associated with survival.Conclusion Approximately one in four Danish patients with NSCLC were diagnosed following emergency admission. This route was strongly associated with advanced stage and poor prognosis, suggesting that emergency admission reflects late-stage disease rather than being an independent prognostic factor. Efforts to reduce diagnosis following emergency admission should focus on early detection, improved symptom awareness, and optimized diagnostic pathways.
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BibTeX
@article{christensen2026routes,
title = {{Routes to diagnosis and survival in Danish patients with non–small cell lung cancer: the impact of emergency admission}},
author = {Niels Lyhne Christensen and Katrine Kristensen and Torben Riis Rasmussen and Morten Hornemann Borg and Amanda Dandanell Juul and Anja Gouliaev},
journal = {European Clinical Respiratory Journal},
year = {2026},
month = oct,
doi = {10.1080/20018525.2026.2739154},
url = {https://doi.org/10.1080/20018525.2026.2739154},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Routes to diagnosis and survival in Danish patients with non–small cell lung cancer: the impact of emergency admission
AU - Niels Lyhne Christensen
AU - Katrine Kristensen
AU - Torben Riis Rasmussen
AU - Morten Hornemann Borg
AU - Amanda Dandanell Juul
AU - Anja Gouliaev
PY - 2026
DA - 2026/10/23
JO - European Clinical Respiratory Journal
DO - 10.1080/20018525.2026.2739154
UR - https://doi.org/10.1080/20018525.2026.2739154
AB - Background Worldwide, lung cancer remains the leading cause of cancer-related death. Studies have shown that receiving a lung cancer diagnosis following an unplanned admission is associated with poor prognosis. The causal relationship between emergency presentation and survival remains uncertain.Methods We conducted a population-based retrospective study including a random sample of 1,000 Danish patients diagnosed with non-small cell lung cancer (NSCLC) between 2014 and 2016, identified through the Danish Lung Cancer Registry. Detailed data on route to diagnosis, stage, performance status, comorbidity, and survival were retrieved from electronic health records. Associations between route to diagnosis and survival were examined using logistic regression adjusted for relevant clinical covariates.Results Of 974 eligible patients, 234 (24%) were diagnosed following emergency admission. These patients were more likely to present with advanced stage (stage IV: 70% vs. 43%) and have poorer performance status. One- and five‑year survival were markedly lower in patients admitted acutely (32% and 8%) compared to non-emergency presenters (56% and 22%; p < 0.001). The adjusted odds ratio for 5-year survival following emergency admission was 0.47 (95% CI 0.28–0.81). After adjusting for disease stage, emergency admission was no longer independently associated with survival.Conclusion Approximately one in four Danish patients with NSCLC were diagnosed following emergency admission. This route was strongly associated with advanced stage and poor prognosis, suggesting that emergency admission reflects late-stage disease rather than being an independent prognostic factor. Efforts to reduce diagnosis following emergency admission should focus on early detection, improved symptom awareness, and optimized diagnostic pathways.
SN - 2001-8525
ER -