General medical practices that offer a routine GP appointment within 48 hours are less likely to have patients diagnosed with cancer for the first time via an emergency hospital admission, according to new research.
And the strongest link to why cancer was diagnosed for the first time through an unplanned hospital admission was to patients living in a deprived area, says the study, which is published in the British Journal of Cancer.
Other characteristics of doctors' surgeries where patients were more likely to be admitted as an emergency included having lower scores for quality awarded through the national Quality and Outcomes Framework (QOF) and having no GPs who received their training in the UK. These links may be related to how practices are organised or the demographics of the areas they serve, suggest the researchers, who are from the Department of Primary Care and Public Health at Imperial College London (ICL).For the study, the authors investigated the reasons why nearly a quarter of cancer patients are diagnosed with their disease through unplanned admissions to hospital - either through A&E or for being in hospital for another reason - rather than through planned or two-week wait appointments.
The researchers looked at patients across nearly 8,000 GP practices who had had a cancer admission for the first time from 2007 to 2010, and they found that 22% - or 139,351 - were "unplanned."
These findings highlight "just how crucial it is for cancer survival to have fast and easy access to primary care," commented study author Dr Alex Bottle."GP practices where more patients are able to get an appointment with their GP within 48 hours were less likely to have patients turn up as emergency admissions to hospital," he said, and also pointed out that the study revealed that the major effect was associated with where the patient lived. Highly-deprived areas were associated with an estimated 1,300 or more extra emergency admissions each year, compared with 300 extra for practice factors, the researchers found.
"Previous work has shown that nearly a quarter of cancer patients are first diagnosed through an emergency admission to hospital, and that these patients have a poorer chance of surviving cancer," said Dr Bottle.
"We wanted to find our if there was anything about these patients - their age, sex, ethnicity, where they lived, the type of cancer they had that meant they were more likely to first present with cancer as an emergency. We also wanted to see whether there were any characteristics of their GP practice that influenced unplanned cancer admissions,” he added.
Commenting on the study's findings, Sara Hiom, director of information at Cancer Research UK, said: "we know that in the UK we have an unacceptably high proportion of cancers being diagnosed via an emergency admission to hospital. This new research provides further pointers as to why these unplanned admissions happen. The important message remains to go to your GP without delay if you have persistent symptoms or unusual bodily changes that worry you."