Recipient organisationNIHR Newcastle Patient Safety Research Collaboration
NIHR supportRecorded as supported by this research centre
PeriodApr 2025 — Dec 2025
In plain English
AI plain-English summary
One in three lung cancer patients and one in four colorectal cancer patients in the UK are diagnosed only after an emergency hospital visit. These patients die sooner than those diagnosed through planned routes, even when their cancer is caught at the same stage. This matters because no one knows why emergency-diagnosed patients fare worse. The problem is not simply late detection—the survival gap persists after accounting for tumour stage. The CAPE study will interview doctors and nurses who treat these patients, asking them to describe the typical care pathways, decision points, and coordination challenges that follow an emergency diagnosis. The researchers will compare these pathways with those for patients diagnosed through urgent GP referrals or screening, looking for differences that could explain the poorer outcomes. If the study succeeds, it will identify specific, actionable weaknesses in how care is delivered after an emergency diagnosis—for example, delays in starting treatment, fragmented handoffs between hospital teams, or gaps in follow-up. The findings could inform changes to NHS protocols, training, or resource allocation that help close the survival gap for tens of thousands of patients each year. This is applied health services research with a direct route to policy and practice.
View original technical description
A high proportion of people with cancer in the UK are diagnosed as an emergency. For example, this applies to around one third of people with lung cancer and a quarter of those with colorectal cancer. We know from our related quantitative research, that there are striking inequalities in emergency presentation in England. It is also known that those who present as an emergency have worse survival outcomes that other patient groups. These disparities persist even after adjusting for important determinants of survival such as stage at diagnosis. This study – called CAPE – will use qualitative methods to begin to explore the reasons for these disparities. The study aims i) to understand possible reasons for the poorer outcomes of cancer patients who present through emergency routes and ii) to suggest possible actions to improve outcomes for this patient group. Interviews will be conducted with a range of healthcare professionals who have experience of lung and colorectal cancer patients who were diagnosed as an emergency. Interviews will explore: typical treatment pathways, decision points, and processes for patients diagnosed with either a lung or colorectal cancer; similarities and differences in pathways and processes for patients diagnosed through an emergency route and those diagnosed through urgent or standard cancer referral pathways; similarities and differences in the pathways and processes of lung and colorectal cancer patients, when diagnosed following an emergency presentation; the possible implications of these differences with respect to patient outcomes; and health professional experiences, and perceived challenges, of managing and coordinating care of lung or colorectal cancer patients diagnosed following an emergency presentation. We hope that the findings will begin to inform actions to help address the worse outcomes in this patient group. HRA approval is in place and we are waiting for R&D approval at participating NHS sites; recruitment and data collection will commence by summer 2025.
Safer Management of Multiple Long-Term Conditions in Disadvantaged Communities
Plain English summaries and category classifications on this site are generated by AI and may not perfectly reflect the original research.
Is something wrong? Let us know