Emergency Department Visits Following Skin cancer Diagnosis: An Australian Study
Emergency department (ED) visits are linked to poorer outcomes for cancer patients. This research investigated the rate, occurrence, and contributing factors among Australian individuals newly diagnosed with malignant skin cancers.
Study Design
Researchers conducted a data-linkage study, tracking adult patients who sought care at the EDs of Royal Melbourne and Western Health hospitals within a year of receiving a diagnosis of malignant skin cancer. Statistical analyses, including logistic and Poisson regressions, were employed to determine which factors influenced both the likelihood and frequency of ED visits.
Findings
Between 2010 and 2018, 3,873 patients received a diagnosis of skin cancer, with 631 specifically diagnosed with melanoma. Approximately 29% of patients presented to the ED at least once (2,119 ED episodes in total; median of 0 visits, with a range of 0-14). Several factors were associated with increased risk. patients aged 75 years or older had a 78% higher odds (Odds Ratio = 1.78, 95% Confidence Interval: 1.47-2.15) and a 52% higher incidence rate (Incidence Risk Ratio = 1.52, 95% Confidence Interval: 1.35-1.70) of ED presentation. Male patients were also more likely to visit the ED (OR = 1.17, 95% CI: 1.01-1.36; IRR = 1.23,95% CI: 1.12-1.35).
Socioeconomic status (SES) also played a role, with both those in the lowest (0-30%) and highest (71-100%) SES brackets demonstrating increased risk (OR = 1.59, 95% CI: 1.24-2.03; IRR = 1.69, 95% CI: 1.45-1.96 and OR = 1.30, 95% CI: 1.07-1.58; IRR = 1.27, 95% CI: 1.12-1.45, respectively). Patients who preferred a language other than English were 47% more likely to present to the ED (OR = 1.47, 95% CI: 1.17-1.84; IRR = 1.49, 95% CI: 1.32-1.69). Prior experience with systemic therapies like chemotherapy or radiotherapy was strongly linked to increased ED visits (OR = 3.77, 95% CI: 2.12-6.71; IRR = 2.36, 95% CI: 1.82-3.05). Conversely, patients younger than 65 years had a lower risk of ED presentation (OR = 0.72, 95% CI: 0.59-0.89; IRR = 0.78, 95% CI: 0.68-0.90).Similar risk factors were observed within the melanoma-specific sub-group.
Implications
This study is the first to detail the prevalence and frequency of ED visits following a skin cancer diagnosis, including melanoma. The findings highlight that older male patients,individuals from both lower and higher socioeconomic backgrounds,those with language barriers,and those receiving cancer treatments are at increased risk of requiring emergency care within a year of diagnosis. These results suggest a need for targeted interventions to improve post-diagnosis care and perhaps reduce avoidable ED presentations for this vulnerable population. Further research could explore the reasons why these groups are more likely to utilize emergency services, potentially identifying gaps in access to timely outpatient care or inadequate support for managing treatment side effects.
Source: Izon, D., et al. (2025). Post-diagnosis Emergency Department Presentation and Demographic Factors in Malignant Skin Cancers: A Data-linkage Cohort Study.Oncology Advances. doi.org/10.14218/ona.2025.00006.