Introduction Lung cancer is a major cause of mortality in the UK, with survival related to stage of disease at presentation. Better understanding of factors contributing to presentation delay might aid earlier identification and assessment of patients. Here we set out to characterise demographic features of the late presenting population at an East London hospital.
Methods Local lung cancer diagnoses between June 2005 and November 2011 (n=554) were retrospectively determined from the National Lung Cancer Audit database. Cases for whom staging information at diagnosis was available, were selected for study (n=460) and divided into those with early (stage I-IIIA, n=135) and late (stage IIIB-IV, n=325) disease. Socioeconomic quintiles based on patients’ postcodes were defined using the Income domain of the Index of Multiple Deprivation 2010. Data were analysed by logistic regression in SPSS.
Results We found increasing age (ORs 0.95, 0.55, 0.58 for age groups <60, 60–69, 70–79 and ≥80 years respectively, p=0.027) to be associated with decreased risk of late presentation.
Male gender (OR=1.59, 95% CI 1.06–2.38, p=0.016) and emergency presentation as opposed to community based referral to services (OR=1.92, 95% CI 1.19–3.10, p=0.008) were associated with advanced stage disease at diagnosis.
Socioeconomic group was not found to contribute significantly to stage of disease at presentation.
Conclusion We report that age, gender but not socioeconomic status are risk factors for late stage of lung cancer at diagnosis. These findings are in line with a recent large study of the East of England cancer registry (BJC 2012; 106:1068–1075). We extend that work to show a relationship between mode of presentation and disease stage at diagnosis, in keeping with national data indicating that emergency presentation is associated with poorer survival outcomes (NCIN 2010).
In summary, this study adds to the increasing evidence that patient factors are associated with potentially avoidable late stage presentations of lung cancer, reiterating the need for targeted health promotion activities to engage at risk patient groups.
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