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What can hospital emergency admissions prior to cancer diagnosis tell us about socio-economic inequalities in cancer diagnosis? Evidence from population-based data in England.
Exarchakou, Aimilia; Rachet, Bernard; Lyratzopoulos, Georgios; Maringe, Camille; Rubio, Francisco Javier.
Afiliação
  • Exarchakou A; Inequalities in Cancer Outcomes Network (ICON), Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK. Aimilia.Exarchakou@lshtm.ac.uk.
  • Rachet B; Inequalities in Cancer Outcomes Network (ICON), Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
  • Lyratzopoulos G; Epidemiology of Cancer Healthcare and Outcomes (ECHO), Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK.
  • Maringe C; Inequalities in Cancer Outcomes Network (ICON), Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
  • Rubio FJ; Department of Statistical Science, University College London, London, UK.
Br J Cancer ; 130(12): 1960-1968, 2024 Jun.
Article em En | MEDLINE | ID: mdl-38671209
ABSTRACT

BACKGROUND:

More deprived cancer patients are at higher risk of Emergency Presentation (EP) with most studies pointing to lower symptom awareness and increased comorbidities to explain those patterns. With the example of colon cancer, we examine patterns of hospital emergency admissions (HEAs) history in the most and least deprived patients as a potential precursor of EP.

METHODS:

We analysed the rates of hospital admissions and their admission codes (retrieved from Hospital Episode Statistics) in the two years preceding cancer diagnosis by sex, deprivation and route to diagnosis (EP, non-EP). To select the conditions (grouped admission codes) that best predict emergency admission, we adapted the purposeful variable selection to mixed-effects logistic regression.

RESULTS:

Colon cancer patients diagnosed through EP had the highest number of HEAs than all the other routes to diagnosis, especially in the last 7 months before diagnosis. Most deprived patients had an overall higher rate and higher probability of HEA but fewer conditions associated with it.

CONCLUSIONS:

Our findings point to higher use of emergency services for non-specific symptoms and conditions in the most deprived patients, preceding colon cancer diagnosis. Health system barriers may be a shared factor of socio-economic inequalities in EP and HEAs.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Fatores Socioeconômicos / Serviço Hospitalar de Emergência / Neoplasias Limite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País como assunto: Europa Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Fatores Socioeconômicos / Serviço Hospitalar de Emergência / Neoplasias Limite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País como assunto: Europa Idioma: En Ano de publicação: 2024 Tipo de documento: Article