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Deprivation biggest factor in delays to early cancer diagnosis, study shows

A large study of emergency admissions for cancer has shown deprivation is by far the biggest factor in delays to early diagnosis of the condition.

Data collected from more than 639,000 patients over three years with a first-time admission for cancer showed that 22% were unplanned admissions.

The analysis showed that in addition to deprivation, women and Asian patients were more likely to have cancer picked up as an emergency.

Some types of cancer, such as brain and lung, were also more likely to present as unplanned admissions, the study published in the British Journal of Cancer found.

At a practice level, being less able to offer appointments within 48 hours was also associated with higher chance of unplanned admissions.

There were also significant links between quality of care as measured by overall QOF scores, and the unplanned route remained more common for patients of practices where no GP gained their primary medical qualification in the UK.

Dr Paul Aylin, study leader and clinical reader in epidemiology and public health at Imperial College London, said individual patient factors far outweighed practice-related factors, with patient deprivation accounting for 1,300 more unplanned admissions per year compared with 300 more for the practice characteristics that were found to be significant.

‘Although GPs aren't responsible for improving levels of deprivation, what they can do with this data is look at some of these high-risk portions of the population and target resources to picking up cancers earlier,' he said.

‘We can't change some of these factors, but we can be alert to the higher possibility of cancer in these patients.'

Professor Willie Hamilton, professor of primary care diagnostics at the Peninsula College of Medicine and Dentistry, said the study was interesting but that it was not necessarily an easy task to know what to do with the results.

‘Many of the correlations are in areas we can't do much about, like practice deprivation, the gender makeup of the practice, even the gender of the patient,' he said.

‘And many are simply explained by the natural history of the disease – brain tumours present with a seizure, which equals an emergency.'

Professor Hamilton added that some findings – such as higher rates of emergency admissions for pancreas and lung cancer – have no obvious explanation, but there may be issues with direct access to diagnostic tests.


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