Your browser doesn't support javascript.
loading
Emergency presentation prior to lung cancer diagnosis: A national-level examination of disparities and survival outcomes.
Gurney, Jason; Davies, Anna; Stanley, James; Signal, Virginia; Costello, Shaun; Dawkins, Paul; Henare, Kimiora; Jackson, Chris; Lawrenson, Ross; Whitehead, Jesse; Koea, Jonathan.
Afiliación
  • Gurney J; Department of Public Health, University of Otago, Wellington, New Zealand. Electronic address: jason.gurney@otago.ac.nz.
  • Davies A; Department of Public Health, University of Otago, Wellington, New Zealand.
  • Stanley J; Department of Public Health, University of Otago, Wellington, New Zealand.
  • Signal V; Department of Public Health, University of Otago, Wellington, New Zealand.
  • Costello S; Southern Blood and Cancer Unit, Te Whatu Ora - Southern, Dunedin, New Zealand.
  • Dawkins P; Respiratory Services, Te Whatu Ora - Counties Manukau, Auckland, New Zealand.
  • Henare K; Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand.
  • Jackson C; Southern Blood and Cancer Unit, Te Whatu Ora - Southern, Dunedin, New Zealand; Department of Medicine, University of Otago, Wellington, New Zealand.
  • Lawrenson R; Medical Research Centre, University of Waikato, Hamilton, New Zealand; Population and Public Health, Te Whatu Ora - Waikato, Hamilton, New Zealand.
  • Whitehead J; Te Ngira Institute for Population Research, University of Waikato, New Zealand.
  • Koea J; General Surgery Services, Te Whatu Ora, Waitemata, Auckland, New Zealand.
Lung Cancer ; 179: 107174, 2023 05.
Article en En | MEDLINE | ID: mdl-36958240
OBJECTIVES: A recent multinational investigation of emergency presentation within 30 days of cancer diagnosis, conducted within the International Cancer Benchmarking Programme (ICBP), observed that New Zealand had the highest rate of emergency presentation prior to lung cancer diagnosis compared to other similar countries. Here we use national-level health data to further investigate these trends, focussing on ethnic disparities in emergency presentation prior to lung cancer diagnosis. We have also compared survival outcomes between those who had an emergency presentation in the preceding 30 days to those who did not. MATERIALS AND METHODS: Our study included all lung cancer registrations between 2007 and 2019 on the New Zealand Cancer Registry (N = 27,869), linked to national hospitalisation and primary healthcare data. We used descriptive (crude and age-standardised proportions) and logistic regression (crude and adjusted odds ratios) analyses to examine primary care access prior to cancer diagnosis, emergency hospitalisation up to and including 30 days prior to diagnosis, and one-year mortality post-diagnosis, both for the total population and between ethnicities. Regression models adjusted for age, sex, deprivation, rurality, comorbidity, tumour type and stage. RESULTS: We found stark disparities by ethnic group, with 62% of Pacific peoples and 54% of Maori having an emergency presentation within 30 days prior to diagnosis, compared to 47% of Europeans. These disparities remained after adjusting for multiple covariates including comorbidity and deprivation (adj. OR: Maori 1.21, 95% CI 1.13-1.30; Pacific 1.50, 95% CI 1.31-1.71). Emergency presentation was associated with substantially poorer survival outcomes across ethnic groups (e.g. 1-year mortality for Maori: no emergency presentation 50%, emergency presentation 79%; adj. OR 2.40, 95% CI 2.10-2.74). CONCLUSIONS: These observations reinforce the need for improvements in the early detection of lung cancer, particularly for Maori and Pacific populations, with a view to preventing diagnosis of these cancers in an emergency setting.
Asunto(s)
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Pulmonares Tipo de estudio: Diagnostic_studies / Screening_studies Límite: Humans / Infant País/Región como asunto: Oceania Idioma: En Revista: Lung Cancer Asunto de la revista: NEOPLASIAS Año: 2023 Tipo del documento: Article Pais de publicación: Irlanda

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Pulmonares Tipo de estudio: Diagnostic_studies / Screening_studies Límite: Humans / Infant País/Región como asunto: Oceania Idioma: En Revista: Lung Cancer Asunto de la revista: NEOPLASIAS Año: 2023 Tipo del documento: Article Pais de publicación: Irlanda