Bowel cancer patients living in the most deprived areas have a 13% higher proportion of emergency hospital admissions before diagnosis than patients in least deprived areas, a new study funded by Cancer Research UK reports.
In the first study of its kind in the UK, researchers based at the London School of Hygiene & Tropical Medicine and at University College London (UCL), analysed hospital admissions data for around 65,000 bowel cancer patients who were diagnosed with the disease between 2011-2013.
The study reveals that among the 8,681 patients who died between three and 12 months after a diagnosis of bowel cancer, 5,809 had an emergency hospital visit before dying. This was around 5% higher among those from more deprived backgrounds.
Overall, it was found that 24,522 bowel cancer patients in the study had at least one emergency hospital visit in the three months before their diagnosis. But 46% of the most deprived patients experienced this, compared to 33% of the least deprived.
Is bowel cancer information reaching deprived areas?
Dr Francisco Rubio, a lead author on the study from the London School of Hygiene & Tropical Medicine, said: “We know that cancer patients from poorer areas are more likely to have emergency visits to hospital in the weeks before their diagnosis, but we found that this also happens after diagnosis. The results are puzzling, as treatment and follow-up are not meant to differ.”
“We can’t tell why this is happening from our research alone, but this study shows us that there are problems which further research needs to look at to pinpoint answers. It may be that information to help people recognise the signs and symptoms of bowel cancer aren’t reaching more deprived groups. After the diagnosis there could be social factors at play, for example a lack of a support network to care for the patients.”
Those diagnosed through the bowel screening programme had a lower proportion of emergency hospital visits after a diagnosis than those who were diagnosed through other routes.
A brighter future for deprived areas
Sara Hiom, director of early diagnosis at Cancer Research UK, said: “When symptoms are picked up quickly and bowel cancer is diagnosed at an early stage, nine in 10 patients survive but when it is detected in the late stages, survival falls to one in 10.
“Research like this is helping us find out how we can make improvements for people from more deprived groups who most need support. The NHS has been trying to reduce unplanned hospital visits for many years, so this is a challenge that the Department of Health & Social Care needs to factor into their plans if they want to reduce health inequalities and increase the number of free hospital beds. Improved access to, and availability of, GPs could help.
She added: “Bowel cancer is the fourth most common cancer in the UK but because the symptoms, such as stomach pain, are often shared with problems such as IBS, it can sometimes be hard to spot. That’s why it’s really important for people to consider taking part in the bowel screening programme when invited; this can spot the disease before symptoms appear.
“This study shows that people diagnosed through screening are less likely to have an emergency hospital visit.”