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Lookup NU author(s): Dr Lynne Forrest, Dr Jean Adams, Professor Martin White, Emeritus Professor Greg RubinORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0).
Background The NHS Cancer Plan for England set waiting time targets for cancer referral [14 days from GP referral to first hospital appointment] and treatment [31 days from diagnosis, 62 days from urgent GP referral]. Interim diagnostic intervals can also be calculated. The factors that influence timely post-primary care referral, diagnosis and treatment for lung cancer are not known. Methods Northern and Yorkshire cancer registry, Hospital Episode Statistics and lung cancer audit data-sets were linked. Logistic regression was used to investigate the factors [socio-economic position, age, sex, histology, co-morbidity, year of diagnosis, stage, and performance status] that may influence the likelihood of referral, diagnosis and treatment within target, for 28,733 lung cancer patients diagnosed in 2006-2010. Results Late-stage, poor performance status and small-cell histology were associated with a higher likelihood of post-primary care referral, diagnosis and treatment within target. Older patients were significantly less likely to receive treatment within the 31 day [odds ratio(OR)=0.79, 95% confidence interval(CI) 0.69 to 0.91] and 62 day target [OR=0.80, 95%CI 0.67 to 0.95] compared to younger patients. Conclusion Older patients waited longer for treatment and this may be unjustified. Patients who appeared ill were referred, diagnosed and treated more quickly and this ‘sicker quicker’ effect may cancel out system socio-economic inequalities that might result in longer time intervals for more deprived patients.
Author(s): Forrest LF, Adams J, White M, Rubin G
Publication type: Article
Publication status: Published
Journal: British Journal of Cancer
Year: 2014
Pages: 1843-1851
Online publication date: 09/09/2014
Acceptance date: 24/07/2014
Date deposited: 01/09/2017
ISSN (print): 0007-0920
ISSN (electronic): 1532-1827
Publisher: Nature Publishing Group
URL: http://dx.doi.org/10.1038/bjc.2014.472
DOI: 10.1038/bjc.2014.472
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