The Leading Reason for Emergency Department Visits in Patients With Cancer: Pain!

Patients with cancer generally visit emergency departments because of sudden, unexpected symptoms related to their disease or treatment. These visits directly affect quality of life, treatment, hospital resource use and the burden on the health system. However, data on which symptoms occur most often before these visits, and which patient groups have a higher symptom burden, are limited.

A new comprehensive study aimed at filling this gap was published on April 22, 2025, in JAMA Network Open . It analyzes symptom patterns and differences by sex, ethnicity and insurance status in detail.

A Study Involving 29 Thousand Patients With Cancer

Led by Chichi Chang at the Bakar Computational Health Sciences Institute at UCSF (University of California San Francisco) in the US, the study examined

• 28708 adult patients with cancerand their unplanned acute-care encounters (emergency department visits or hospital admissions).

• For each encounter, clinical notes in electronic health records from the preceding 30 dayswere analyzed with natural language processing (NLP) to identify symptoms.

• A total of 70606 acute-care encounters and 854830 symptoms were documented.

• “High symptom burden” was defined as documentation, within the same 30-day period, of more than 10 different symptoms .

Related Topic: Cancer Pain — What Is It, How Does It Develop and How Is It Treated?

Most Common Symptoms

The study ranked the 10 most frequently documented symptoms before acute-care encounters as follows:

Painwas by far the most common symptom on this list, highlighting the importance of palliative care and pain control.

Who Experiences More Symptoms?

The study also found significant differences between demographic groups:

• Womenhad a higher symptom burden than men (14% higher, aOR: 1.14).
• Asian (22%), Black (17%) and American Indian / Alaska Native (21%) patients had a higher symptom burden than White individuals.
• Patients with government insurance (Medicaid)had a higher symptom burden than those with private insurance (10%).
• In contrast, people older than 65 (4%) and uninsured patients (42%) reported fewer symptoms.

These data show how strongly socioeconomic factors may influence access to health care and symptom expression.

Clinical Interpretation and Application

Differences in symptom documentation between sociodemographic groups suggest possible health-care inequalities. These findings indicate a need for targeted interventions, particularly to improve symptom management and reduce emergency visits.

These results concern not only individual patient care but also health policy. Higher symptom burdens among women, ethnic minorities and publicly insured individuals may require support mechanisms tailored to these groups.

Conclusion and Recommendations

Understanding why patients with cancer visit emergency departments is critical to developing strategies to prevent these visits. For controllable symptoms such as pain, nausea and fatigue, early detection and effective management may improve quality of life and reduce the burden on the health system.

• Symptom monitoringshould become more systematic in clinical practice.
• High-risk patient groups (women, ethnic minorities and low-income groups) should have tailored support mechanisms.
• Emergency department visits should be viewed as an opportunity to optimize symptom management protocols.