Repository logo
 

Are inequalities in cancer diagnosis through emergency presentation narrowing, widening or remaining unchanged? Longitudinal analysis of English population-based data 2006-2013.

Simple item page
cam.issuedOnline2018-11-08
dc.contributor.authorHerbert, Annie
dc.contributor.authorAbel, Gary A
dc.contributor.authorWinters, Sam
dc.contributor.authorMcPhail, Sean
dc.contributor.authorElliss-Brookes, Lucy
dc.contributor.authorLyratzopoulos, Georgios
dc.contributor.orcidAbel, Gary A [0000-0003-2231-5161]
dc.date.accessioned2018-12-04T00:30:15Z
dc.date.available2018-12-04T00:30:15Z
dc.date.issued2019-01
dc.description.abstractBACKGROUND: Diagnosis of cancer through emergency presentation is associated with poorer prognosis. While reductions in emergency presentations have been described, whether known sociodemographic inequalities are changing is uncertain. METHODS: We analysed 'Routes to Diagnosis' data on patients aged ≥25 years diagnosed in England during 2006-2013 with any of 33 common or rarer cancers. Using binary logistic regression we determined time-trends in diagnosis through emergency presentation by age, deprivation and cancer site. RESULTS: Overall adjusted proportions of emergency presentations decreased during the study period (2006: 23%, 2013: 20%). Substantial baseline (2006) inequalities in emergency presentation risk by age and deprivation remained largely unchanged. There was evidence (p<0.05) of reductions in the risk of emergency presentations for most (28/33) cancer sites, without apparent associations between the size of reduction and baseline risk (p=0.26). If there had been modest reductions in age inequalities (ie, patients in each age group acquiring the same percentage of emergency presentations as the adjacent group with lower risk), in the last study year we could have expected around 11 000 fewer diagnoses through emergency presentation (ie, a nationwide percentage of 16% rather than the observed 20%). For similarly modest reductions in deprivation inequalities, we could have expected around 3000 fewer (ie, 19%). CONCLUSION: The proportion of cancer diagnoses through emergency presentation is decreasing but age and deprivation inequalities prevail, indicating untapped opportunities for further improvements by reducing these inequalities. The observed reductions in proportions across nearly all cancer sites are likely to reflect both earlier help-seeking and improvements in diagnostic healthcare pathways, across both easier-to-suspect and harder-to-suspect cancers.
dc.description.sponsorshipCancer Research UK C18081/A18180 Cancer Research UK C8640/A23385
dc.format.mediumPrint-Electronic
dc.identifier.doi10.17863/CAM.33547
dc.identifier.eissn1470-2738
dc.identifier.issn0143-005X
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/286234
dc.languageeng
dc.language.isoeng
dc.publisherBMJ
dc.publisher.urlhttp://dx.doi.org/10.1136/jech-2017-210371
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectageing
dc.subjectcancer
dc.subjectdeprivation
dc.subjectinequalities
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectEmergency Service, Hospital
dc.subjectEngland
dc.subjectFemale
dc.subjectHumans
dc.subjectIncidence
dc.subjectLongitudinal Studies
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectNeoplasms
dc.subjectPrognosis
dc.subjectRisk Factors
dc.titleAre inequalities in cancer diagnosis through emergency presentation narrowing, widening or remaining unchanged? Longitudinal analysis of English population-based data 2006-2013.
dc.typeArticle
dcterms.dateAccepted2018-08-31
prism.endingPage10
prism.issueIdentifier1
prism.publicationDate2019
prism.publicationNameJ Epidemiol Community Health
prism.startingPage3
prism.volume73
rioxxterms.licenseref.startdate2019-01
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1136/jech-2017-210371

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
jech-2017-210371.full.pdf
Size:
991.12 KB
Format:
Adobe Portable Document Format
Description:
Published version
Licence
https://creativecommons.org/licenses/by/4.0/
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
DepositLicenceAgreementv2.1.pdf
Size:
150.9 KB
Format:
Adobe Portable Document Format
Download

Collections

Cambridge University Research Outputs