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Who Presents Where? A Population-Based Analysis of Socio-Demographic Inequalities in Head and Neck Cancer Patients’ Referral Routes

Head and neck cancers (HNC) are often late stage at diagnosis; stage is a major determinant of prognosis. The urgent cancer referral pathway (two week wait; 2WW) within England’s National Health Service aims to reduce time to diagnosis. We investigated factors associated with HNC route to diagnosis....

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Autores principales: Deane, Jennifer, Norris, Ruth, O’Hara, James, Patterson, Joanne, Sharp, Linda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9779534/
https://www.ncbi.nlm.nih.gov/pubmed/36554605
http://dx.doi.org/10.3390/ijerph192416723
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author Deane, Jennifer
Norris, Ruth
O’Hara, James
Patterson, Joanne
Sharp, Linda
author_facet Deane, Jennifer
Norris, Ruth
O’Hara, James
Patterson, Joanne
Sharp, Linda
author_sort Deane, Jennifer
collection PubMed
description Head and neck cancers (HNC) are often late stage at diagnosis; stage is a major determinant of prognosis. The urgent cancer referral pathway (two week wait; 2WW) within England’s National Health Service aims to reduce time to diagnosis. We investigated factors associated with HNC route to diagnosis. Data were obtained from the English population-based cancer registry on 66,411 primary invasive HNCs (ICD C01-14 and C31-32) diagnosed 2006–2014. Multivariable logistic regression determined the likelihood of different diagnosis routes by patients’ demographic and clinical characteristics. Significant socio-demographic inequalities were observed. Emergency presentations declined over time and 2WW increased. Significant socio-demographic inequalities were observed. Non-white patients, aged over 65, residing in urban areas with advanced disease, were more likely to have emergency presentations. White males aged 55 and older with an oropharynx cancer were more likely to be diagnosed via 2WW. Higher levels of deprivation were associated with both emergency and 2WW routes. Dental referral was more likely in women, with oral cancers and lower stage disease. Despite the decline over time in emergency presentation and the increased use of 2WW, socio-demographic variation is evident in routes to diagnosis. Further work exploring the reasons for these inequalities, and the consequences for patients’ care and outcomes, is urgently required.
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spelling pubmed-97795342022-12-23 Who Presents Where? A Population-Based Analysis of Socio-Demographic Inequalities in Head and Neck Cancer Patients’ Referral Routes Deane, Jennifer Norris, Ruth O’Hara, James Patterson, Joanne Sharp, Linda Int J Environ Res Public Health Article Head and neck cancers (HNC) are often late stage at diagnosis; stage is a major determinant of prognosis. The urgent cancer referral pathway (two week wait; 2WW) within England’s National Health Service aims to reduce time to diagnosis. We investigated factors associated with HNC route to diagnosis. Data were obtained from the English population-based cancer registry on 66,411 primary invasive HNCs (ICD C01-14 and C31-32) diagnosed 2006–2014. Multivariable logistic regression determined the likelihood of different diagnosis routes by patients’ demographic and clinical characteristics. Significant socio-demographic inequalities were observed. Emergency presentations declined over time and 2WW increased. Significant socio-demographic inequalities were observed. Non-white patients, aged over 65, residing in urban areas with advanced disease, were more likely to have emergency presentations. White males aged 55 and older with an oropharynx cancer were more likely to be diagnosed via 2WW. Higher levels of deprivation were associated with both emergency and 2WW routes. Dental referral was more likely in women, with oral cancers and lower stage disease. Despite the decline over time in emergency presentation and the increased use of 2WW, socio-demographic variation is evident in routes to diagnosis. Further work exploring the reasons for these inequalities, and the consequences for patients’ care and outcomes, is urgently required. MDPI 2022-12-13 /pmc/articles/PMC9779534/ /pubmed/36554605 http://dx.doi.org/10.3390/ijerph192416723 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Deane, Jennifer
Norris, Ruth
O’Hara, James
Patterson, Joanne
Sharp, Linda
Who Presents Where? A Population-Based Analysis of Socio-Demographic Inequalities in Head and Neck Cancer Patients’ Referral Routes
title Who Presents Where? A Population-Based Analysis of Socio-Demographic Inequalities in Head and Neck Cancer Patients’ Referral Routes
title_full Who Presents Where? A Population-Based Analysis of Socio-Demographic Inequalities in Head and Neck Cancer Patients’ Referral Routes
title_fullStr Who Presents Where? A Population-Based Analysis of Socio-Demographic Inequalities in Head and Neck Cancer Patients’ Referral Routes
title_full_unstemmed Who Presents Where? A Population-Based Analysis of Socio-Demographic Inequalities in Head and Neck Cancer Patients’ Referral Routes
title_short Who Presents Where? A Population-Based Analysis of Socio-Demographic Inequalities in Head and Neck Cancer Patients’ Referral Routes
title_sort who presents where? a population-based analysis of socio-demographic inequalities in head and neck cancer patients’ referral routes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9779534/
https://www.ncbi.nlm.nih.gov/pubmed/36554605
http://dx.doi.org/10.3390/ijerph192416723
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