(Deprivation and emergency admission for cancers of colorectum, lung and breast in south east England: ecological study)
A major reorganisation of cancer services is underway in England and Wales in response to the Calman-Hine Report (1994), with the aim of improving access to and quality of cancer treatment. In this week's BMJ Dr Allyson Pollock and Neil Vickers from St George's Hospital Medical School in London report their findings in the first study in the UK to consider sociodemographic differences in the treatment of patients with lung, bowel and breast cancers.
Pollock and Vickers found that people with these cancers living in deprived areas in the Thames region, were more likely to be admitted as emergencies and ordinary inpatients than their counterparts from more affluent areas. They also found that patients with lung or breast cancers from deprived areas were less likely to receive surgical treatment.
For most cancers, the stage at which patients report their symptoms is the single most important determinant of their outcome - the earlier a diagnosis is made the more likely a patient is to survive. The authors conclude that if reductions in mortality are to be achieved, more effective early diagnostic and referral procedures in primary care in deprived areas are required. They also suggest that hospital mergers and plans of service reconfiguration and bed closures must take into account the current inequities in access to treatment among residents in deprived areas.
Dr Allyson Pollock, Senior Lecturer in Public Health Medicine, Department of Public Health Sciences, St George's Hospital Medical School, London