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dc.contributor.authorHayes, Louise
dc.contributor.authorAdams, Jean
dc.contributor.authorMcCallum, Iain
dc.contributor.authorForrest, Lynne
dc.contributor.authorHidajat, Mira
dc.contributor.authorWhite, Martin
dc.contributor.authorSharp, Linda
dc.date.accessioned2020-06-23T23:30:44Z
dc.date.available2020-06-23T23:30:44Z
dc.date.issued2021-01
dc.identifier.issn0143-005X
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/307171
dc.description.abstractBACKGROUND: Poorer colorectal cancer survival in the UK than in similar countries may be partly due to delays in the care pathway. To address this, cancer waiting time targets were established. We investigated if socio-demographic inequalities exist in meeting cancer waiting times for colorectal cancer. METHODS: We identified primary colorectal cancers (International Classification of Diseases, Tenth Revision C18-C20; n=35 142) diagnosed in the period 2001-2010 in the Northern and Yorkshire Cancer Registry area. Using multivariable logistic regression, we calculated likelihood of referral and treatment within target by age group and deprivation quintile. RESULTS: 48% of the patients were referred to hospital within target (≤14 days from general practitioner (GP) referral to first hospital appointment); 52% started treatment within 31 days of diagnosis; and 44% started treatment within 62 days of GP referral. Individuals aged 60-69, 70-79 and 80+ years were significantly more likely to attend a first hospital appointment within 14 days than those aged <60 years (adjusted OR=1.23, 95% CI 1.12 to 1.34; adjusted OR=1.19, 95% CI 1.09 to 1.29; adjusted OR=1.30, 95% CI 1.18 to 1.42, respectively). Older age was significantly associated with lower likelihood of starting treatment within 31 days of diagnosis and 62 days of referral. Deprivation was not related to referral within target but was associated with lower likelihood of starting treatment within 31 days of diagnosis or 62 days of referral (most vs least: adjusted OR=0.82, 95% CI 0.74 to 0.91). CONCLUSIONS: Older patients with colorectal cancer were less likely to experience referral delays but more likely to experience treatment delays. More deprived patients were more likely to experience treatment delays. Investigation of patient pathways, treatment decision-making and treatment planning would improve understanding of these inequalities.
dc.description.sponsorshipThis study was supported by the National Institute for Health Research (NIHR) School for Public Health Research (Grant Reference Numbers: SPHR-SWP-AGP-PR3 and PD-SPH-2015). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. At the time of the data request, the SPHR was a partnership between the Universities of Sheffield, Bristol, Cambridge; UCL; The London School for Hygiene and Tropical Medicine; The Peninsula College of Medicine and Dentistry; the LiLaC collaboration between the Universities of Liverpool and Lancaster and Fuse. Fuse is a UK Clinical Research Collaboration (UKCRC) Public Health Research Centre of Excellence. Funding for Fuse from British Heart Foundation, Cancer Research UK, National Institute of Health Research, Economic and Social Research Council, Medical Research Council, Health and Social Care Research and Development Office, Northern Ireland, National Institute for Social Care and Health Research (Welsh Assembly Government) and the Wellcome Trust, under the auspices of the UKCRC, is gratefully acknowledged.
dc.format.mediumPrint-Electronic
dc.languageeng
dc.publisherBMJ
dc.rightsAll rights reserved
dc.subjectHumans
dc.subjectColorectal Neoplasms
dc.subjectRegistries
dc.subjectSocioeconomic Factors
dc.subjectAged
dc.subjectReferral and Consultation
dc.titleAge-related and socioeconomic inequalities in timeliness of referral and start of treatment in colorectal cancer: a population-based analysis.
dc.typeArticle
prism.endingPage9
prism.issueIdentifier1
prism.publicationDate2021
prism.publicationNameJ Epidemiol Community Health
prism.startingPage1
prism.volume75
dc.identifier.doi10.17863/CAM.54266
dcterms.dateAccepted2020-06-20
rioxxterms.versionofrecord10.1136/jech-2020-214232
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2021-01
dc.contributor.orcidHayes, Louise [0000-0001-6442-4150]
dc.contributor.orcidSharp, Linda [0000-0001-9515-1722]
dc.identifier.eissn1470-2738
rioxxterms.typeJournal Article/Review
pubs.funder-project-idMedical Research Council (MR/K023187/1)
pubs.funder-project-idDepartment of Health (via National Institute for Health Research (NIHR)) (unknown)
pubs.funder-project-idWellcome Trust (087636/Z/08/Z)
pubs.funder-project-idEconomic and Social Research Council (ES/G007462/1)
pubs.funder-project-idDepartment of Health (via National Institute for Health Research (NIHR)) (PD-SPH-2015-10029 BH154142)
pubs.funder-project-idMRC (MC_UU_00006/7)
cam.issuedOnline2020-10-14
cam.orpheus.successMon Nov 02 07:32:07 GMT 2020 - Embargo updated
cam.orpheus.counter19
rioxxterms.freetoread.startdate2020-10-14


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