Lung cancer diagnosis in the emergency department.

Lung cancer is the leading cause of cancer death worldwide, both in men and women, with an estimated incidence of 1.3 million cases per year. Active, but also passive, smoking represents the main risk factor for developing lung cancer. Smoking also causes other major health complications that could lead the smoker, whether they have cancer or not, to the emergency department (acute exacerbations of chronic obstructive pulmonary disease, acute coronary events, etc.). Regardless of smoking, cancer patients require emergency visits with high frequency, at equal rates for complications related to the cancer itself (neoplastic involvement of specific organs, cancer-related immunosuppression, etc.) and its treatment (haematological events, stomatitis, chemotherapy-related vomiting, etc.), and for cancer-unrelated problems. This setting was summarised in a systematic review including only six prospective series from the 18 selected, which generally were of limited size (median 143 patients) [1]. A few other works have confirmed that lung cancer patients are a major component of those people consulting at the emergency department [2–4]. In a Belgian cancer hospital, we previously noted that 8% of all consultations in this context were lung cancer patients [5]. It was also noted that up to 40% of the patients with lung cancer will present to the emergency department at least once during the course of their disease [5].