The impact of the UK ‘two-week rule’ on stage-on-diagnosis of oral cancer and the relationship to socio-economic inequalities

Langton, S.G.; Lowe, Derek; Rogers, Simon; Plüddemann, Annette; Bankhead, Clare

doi:10.1016/j.jcpo.2019.100191

Cited by 3 publications

(6 citation statements)

References 24 publications

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“…Langton et al, 2019, found that there was an association between deprivation and tumour presentation at diagnosis [15]. The level of patients presenting with late stage 3 or 4 oral cancer decreased in areas of increased deprivation between the reported years 1992-2000 (56%; 95% CI 48.7-62.5%; 118/212) and 2001-2012 (47%; 95% CI 42.2-51.2%; 233/499).…”

Section: Cancermentioning

confidence: 99%

“…Both studies documenting the association between tumour presentation and deprivation reported that people from areas of greater deprivation were diagnosed more frequently with late stage 3 or 4 UATC [15,43]. Although the gap between the more deprived and least deprived has decreased since the introduction of the "two-week rule", there are still a greater number of patients in low socio-economic areas being diagnosed with late stage oral cancer [15]. Prevalence of disease recorded was greater in in areas of lower IMD scores [15].…”

Section: Cancermentioning

confidence: 99%

“…Although the gap between the more deprived and least deprived has decreased since the introduction of the "two-week rule", there are still a greater number of patients in low socio-economic areas being diagnosed with late stage oral cancer [15]. Prevalence of disease recorded was greater in in areas of lower IMD scores [15]. This may be due to the social determinants of health affecting overall lifestyle choices.…”

Section: Cancermentioning

confidence: 99%

“…Recommendations are based on NHS and NICE guidelines. Information was sourced from various resources [14][15][16][17][18][19][20][21]. Refer to the list of abbreviations.…”

Section: Introduction 1rationalementioning

confidence: 99%

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Socio-Economic Disparities in Access to Diagnostic Neuroimaging Services in the United Kingdom: A Systematic Review

Karia

Zamani

Akrami

2021

IJERPH

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Socio-economic factors affecting health care can lead to delays in diagnosis of neurological conditions, consequentially affecting treatment and morbidity rates. This inequality in health care can leave patients from lower socio-economic backgrounds more vulnerable to a poorer quality of care from health care providers in the United Kingdom (U.K.). Aims: In this systematic review, we assess the impact of socio-economic status on the use of diagnostic neuroimaging in the U.K., measured by the timeliness, accessibility and appropriate use of computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography, electroencephalography (EEG) and single-photon emission computed tomography (SPECT). We specifically evaluate the non-surgical use of neuroimaging techniques as this relies on the judgment of primary care-givers (e.g., doctors and radiologists), where health disparities are most common. This study includes the analysis of diagnostic imaging used for dementia, minor head injury, stroke, cancer, epilepsy, chronic inflammatory demyelinating polyneuropathy and Parkinson’s disease. With this study, we aim to assess the health inequalities at disease diagnosis. Methods: Using Medline (via Ovid), PubMed and Web of Science databases as sources of information, we critically appraise existing studies on neuroimaging use in the U.K. health care system, published between January 2010 and February 2021. Findings: A total of 18 studies were included in this research, revealing that there was an increase in patients of Black and Asian communities diagnosed with dementia and at an earlier age. There was little evidence to suggest that a lack of access to diagnostic imaging is associated with socio-economic status. However, there are data to suggest that people of a lower socio-economic background require more specialist services with diagnostic neuroimaging tools. In addition, there is evidence to suggest that diagnostic neuroimaging techniques could be utilised more effectively by health care workers to prevent unnecessary delays in diagnosis for patients in lower socio-economic areas.

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Section: Cancermentioning

confidence: 99%

Section: Cancermentioning

confidence: 99%

Section: Cancermentioning

confidence: 99%

“…Recommendations are based on NHS and NICE guidelines. Information was sourced from various resources [14][15][16][17][18][19][20][21]. Refer to the list of abbreviations.…”

Section: Introduction 1rationalementioning

confidence: 99%

See 2 more Smart Citations

Socio-Economic Disparities in Access to Diagnostic Neuroimaging Services in the United Kingdom: A Systematic Review

Karia

Zamani

Akrami

2021

IJERPH

View full text Add to dashboard Cite

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“…24 25 A Monte Carlo permutation test assessed the significance of changing trends (i.e., APC). 27 Joinpoint regression analysis might be employed when the temporal trend of a given quantity (e.g., proportions, rates, counts), such as incidence and mortality (e.g., referring to cancer-related scenarios), was of interest. [28][29][30] It is valuable to generate quantitative inferences instead of qualitative ones in epidemiological studies.…”

Section: Extraction and Definition Of Variablesmentioning

confidence: 99%

Analysing 11 years of incidence trends, clinicopathological characteristics, and forecasts of colorectal cancer in young and old patients: a retrospective cross-sectional study in an Indonesian national referral hospital

et al. 2022

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ObjectiveTo obtain annual incidence trends, understand clinicopathological characteristics, and forecast the future burden of colorectal cancer (CRC) in Indonesia.Design11-year retrospective cross-sectional study.SettingA national referral hospital in Jakarta, Indonesia.ParticipantsData from 1584 eligible cases were recorded for trends and forecasting analyses; 433 samples were analysed to determine clinicopathological differences between young (<50 years) and old (≥50 years) patients.MethodsTrend analyses were done using Joinpoint software, expressed in annual percentage change (APC), and a regression analysis was executed to generate a forecasting model. Patients’ characteristics were compared using χ2 or non-parametric tests.Main outcomesAnalysis of trends, forecasting model, and clinicopathological features between the age groups.ResultsA significant increase in APC was observed among old patients (+2.38%) for CRC cases. Colon cancer increased remarkably (+9.24%) among young patients; rectal cancer trends were either stable or declining. The trend for right-sided CRC increased in the general population (+6.52%) and old patients (+6.57%), while the trend for left-sided CRC was stable. These cases are expected to be a significant health burden within the next 10 years. Patients had a mean age of 53.17±13.94, 38.1% were young, and the sex ratio was 1.21. Prominent characteristics were left-sided CRC, tumour size ≥5 cm, exophytic growth, adenocarcinoma, histologically low grade, pT3, pN0, inadequately dissected lymph nodes (LNs), LN ratio <0.05, no distant metastasis, early-stage cancer, no lymphovascular invasion, and no perineural invasion (PNI). Distinct features between young and old patients were found in the histological subtype, number of dissected LN, and PNI of the tumour.ConclusionsEpidemiological trends and forecasting analyses of CRC cases in Indonesian patients showed an enormous increase in colon cancer in young patients, a particularly concerning trend. Additionally, young patients exhibited particular clinicopathological characteristics that contributed to disease severity.

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Re: re: Two-week rule: suspected head and neck cancer referrals from a general medical practice perspective

Rogers

Dailey

Langton³

2021

British Journal of Oral and Maxillofacial Surgery

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The impact of the UK ‘two-week rule’ on stage-on-diagnosis of oral cancer and the relationship to socio-economic inequalities

Cited by 3 publications

References 24 publications

Socio-Economic Disparities in Access to Diagnostic Neuroimaging Services in the United Kingdom: A Systematic Review

Socio-Economic Disparities in Access to Diagnostic Neuroimaging Services in the United Kingdom: A Systematic Review

Analysing 11 years of incidence trends, clinicopathological characteristics, and forecasts of colorectal cancer in young and old patients: a retrospective cross-sectional study in an Indonesian national referral hospital

Re: re: Two-week rule: suspected head and neck cancer referrals from a general medical practice perspective

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