Deane, Jennifer, Norris, Ruth, O'Hara, James, Patterson, Joanne 
ORCID: 0000-0001-8898-8292 and Sharp, Linda
(2022)
Who Presents Where? A Population-Based Analysis of Socio-Demographic Inequalities in Head and Neck Cancer Patients' Referral Routes.
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 19 (24).
16723-.
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Abstract
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.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | head and neck cancer, routes to diagnosis, socio-demographic inequalities, healthcare inequalities, emergency presentation |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health Faculty of Health and Life Sciences > Institute of Population Health > School of Health Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 16 Feb 2023 14:36 |
| Last Modified: | 16 Feb 2023 14:37 |
| DOI: | 10.3390/ijerph192416723 |
| Open Access URL: | https://doi.org/10.3390/ijerph192416723 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3168452 |
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