Medical

One third of elderly cancers diagnosed in A&E

Kings College Hospital A&E by C Ford for Expert Witness storyNearly one third of cancers in the over 70s are diagnosed following emergency admission to hospital, according to new research by the National Cancer Intelligence Network (NCIN) and published on 21 September in the British Journal of Cancer.

The research found that 31% of cancers in that age group – around 38,300 a year in England – are diagnosed through an emergency presentation, compared to 24%, or around 58,400 cases a year, in all age groups. This new study examined the journey of 739,667 cancer patients between 2006 and 2008 in England, working backwards to see how they were diagnosed with cancer and the sequence of events that took them there.

In those over 70, around 70% of cancers of the central nervous system and over half of pancreatic (55%) and liver (52%) cancers were first diagnosed after an emergency admission to hospital. Patients presented in a variety of ways, including coming into A&E due to their cancer symptoms, coming into A&E for another reason and having cancer detected, or being referred straight to A&E by their GP because their cancer symptoms are so severe. Experts reacted with shock to the findings.

Sara Hiom, director of information at Cancer Research UK and one of the study authors, said: "Our findings showing the sheer numbers of cancer patients first seen as an emergency are startling. Early diagnosis of cancer, when the most effective treatments are more likely to be options, helps improve a patient's chance of surviving their disease.

"We don't yet know the reasons that lie behind these stark figures but, although we might expect higher numbers of older patients to have cancer detected as an emergency, we urgently need to understand why there is such a great proportion."

Prof Jane Maher, the chief medical officer of Macmillan Cancer Support, said in a response to the publication: "It is appalling that so many cancer patients are still diagnosed through emergency admissions, with 65% of them over 70. This route to diagnosis can have a disastrous impact on survival chances.

"It can be more difficult to spot cancer symptoms in older people who have other health conditions but this does not excuse such a high number of people being diagnosed in this way. All cancer patients should be given the best possible survival chance and we owe it to the older members of our society to ensure that this applies equally to them."