Sociodemographic factors and delays in the diagnosis of six cancers: analysis of data from the ‘National Survey of NHS Patients: Cancer’

Abstract

This paper aims to explore the relationship between sociodemographic factors and the components of diagnostic delay (total, patient and primary care, referral, secondary care) for these six cancers (breast, colorectal, lung, ovarian, prostate, or non-Hodgkin's lymphoma). Secondary analysis of patient-reported data from the 'National Survey of NHS patients: Cancer' was undertaken (65 192 patients). Data were analysed using univariate analysis and Generalised Linear Modelling. With regard to total delay, the findings from the GLM showed that for colorectal cancer, the significant factors were marital status and age, for lung and ovarian cancer none of the factors were significant, for prostate cancer the only significant factor was social class, for non-Hodgkin's lymphoma the only significant factor was age, and for breast cancer the significant factors were marital status and ethnic group. Where associations between any of the component delays were found, the direction of the association was always in the same direction (female subjects had longer delays than male subjects, younger people had longer delays than older people, single and separated/divorced people had longer delays than married people, lower social class groups had longer delays than higher social class groups, and Black and south Asian people had longer delays than white people). These findings should influence the design of interventions aimed at reducing diagnostic delays with the aim of improving morbidity, mortality, and psychological outcomes through earlier stage diagnosis.

Mortality from all cancers and lung, colorectal, breast and prostate cancer by country of birth in England and Wales, 2001–2003

“…Data regarding the use of health services among people with cancer from different ethnic groups are limited. A study of the relationship between socio-demographic factors and the components of diagnostic delay (total, patient and primary care, referral and secondary care) for six cancers (breast, colorectal, lung, ovarian, prostate and non-Hodgkin's lymphoma) found that there was greater diagnostic delay for breast cancer for black and South Asian groups (Neal and Allgar, 2005). …”

The feasibility and results of a population-based approach to evaluating prostate-specific antigen screening for prostate cancer in men with a raised familial risk

“…Data on socio-economic status were not collected. The higher detection of prostate cancer in non-manual than manual social class groups is partly considered to reflect difference in use of health service (Neal and Allgar, 2005), and similar trends are likely to be seen in relatives.…”

The relation between socioeconomic and demographic factors and tumour stage in women diagnosed with breast cancer in Denmark, 1983–1999

“…It remains unclear whether the reason for the disparity by risk-group is delay in diagnosis or differing biology of cancers in the groups with less education and income compared with more advantaged groups. A recent study of UK cancer patients has shown that delay of diagnosis and treatment was longer for lower social class groups than higher social class groups and this was also apparent for breast cancer (Neal and Allgar, 2005). This delay might be a result of lower levels of knowledge regarding significant symptoms and as a result of poorer access to services.…”