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15-08-2012 | General practice | Article

Deprivation key in emergency cancers


Br J Cancer 2012; Advance online publication

MedWire News: Living in a deprived area is the key underlying factor among patients whose cancer is only diagnosed once it has become an emergency, researchers report.

Not being able to book a routine GP appointment within 48 hours was the other major predictor of a first cancer diagnosis via an emergency admission to hospital, their study showed.

Lead author Dr Alex Bottle (Imperial College London) said: "Our new research highlights just how crucial it is for cancer survival to have fast and easy access to primary care. GP practices where more patients are able to get an appointment with their GP within 48 hours were less likely to have patients turn up as emergency admissions to hospital.

"However, the biggest effect was associated with where the patient lived. Highly deprived areas were associated with an estimated 1,300 or more extra emergency admissions each year, compared with 300 extra for practice factors."

Dr Bottle and colleagues found over a fifth of cancer patients are diagnosed through unplanned admissions to hospital, rather than through planned or 2-week wait appointments. Specifically, of 639,064 first-time cancer admissions - among patients from nearly 8,000 practices - between 2007 and 2010, 139,351 (22%) were unplanned.

Their analysis showed that patients from the most deprived-quintile areas were 1.4 times as likely to have an unplanned cancer admission as those in the least deprived-quintile areas.

Regarding practice factors, patients who were able to book an appointment within 48 hours were 15% less likely to have an unplanned admission than those whose practices did not offer 48-hour appointments.

Conversely, practices with lower QOF performance and those without any GPs with a UK primary medical qualification were more likely to have patients with unplanned cancer admissions.

The practice factors identified "raise questions about the role of organisation of practices and staff training", the authors note. They suggest that, in addition to more rapid access to diagnostic services and cancer specialists, one way to help identify cancer earlier would be for GPs to obtain advice and support from specialist services when they experience complications.

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Caroline Price