Improving Cancer Diagnosis in Alberta, Canada: A Qualitative Study of Emergency Department Healthcare Providers' Perspectives on Diagnosing Cancer in the Emergency Setting

Cancer is the leading cause of death in Canada, with diagnoses increasing annually. In Alberta, many cancer cases are detected in emergency departments, often at advanced stages. Despite the significant role of emergency departments in cancer diagnosis, limited research exists on the experiences of healthcare providers in this context. This qualitative study aimed to explore the perspectives of physicians and nurses working in emergency departments in Edmonton and Calgary regarding cancer diagnosis. Semi-structured interviews were conducted with 17 physicians and nurses, recruited through convenience and snowball sampling. Data collection continued until thematic saturation was reached. Interviews were analyzed thematically using an inductive, iterative process. Three main themes emerged: the acute care focus of the emergency department, its unsuitability for cancer diagnosis, and the need for systemic improvements to better support patients with suspected cancer. Participants highlighted challenges related to high patient volumes, the emotional burden of delivering cancer diagnoses, and barriers to effective communication and patient interaction in a fast-paced, high-pressure environment. The findings suggest the need for systemic reforms, including stronger primary care and improved care coordination, to alleviate pressure on emergency departments and enhance both patient outcomes and healthcare provider well-being.