Are inequalities in cancer diagnosis through emergency presentation narrowing, widening or remaining unchanged?

Diagnosis of cancer through emergency presentation is associated with poorer prognosis. Although reductions in emergency presentations have been reported, whether sociodemographic inequalities are changing is uncertain. A longitudinal analysis of English population data was analysed for patients aged 25 and over, diagnosed with any of 33 common or rarer cancers during 2006-2013. Overall, emergency presentations decreased during the study period, but the substantial baseline inequalities in emergency presentation risk by age and deprivation remained largely unchanged. If there had been modest reductions in age inequalities (i.e. patients in each age group acquiring the same percentage of emergency presentations as the adjacent group with lower risk), in the last study year, around 11 000 fewer cases would be diagnosed as emergencies. For similarly modest reductions in deprivation inequalities, there would be 3000 fewer cases diagnosed through emergency presentation. The proportion of cancer diagnoses through emergency presentation is decreasing, but age and deprivation inequalities remain unchanged. These findings highlight the need to target these population subgroups who are at the greatest risk, and to improve the quality of their diagnostic care.

 

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