10 January 2013

Inequalities faced by East Yorkshire cancer patients to be investigated

A major investigation into inequalities faced by cancer patients in East Yorkshire is to be led by HYMS Professor of Primary Care Medicine Una Macleod.

The five-year project, funded by a £750,000 grant from Yorkshire Cancer Research, will seek to address issues relating to the diagnosis and experience of people with cancer throughout the Hull area.

Poor survival rates have been linked to delays in the diagnosis of cancer, and the first part of the study will concentrate on understanding how people interpret symptoms and the factors that make them go and see their doctor.

Cancer patients in East Yorkshire will be invited to take part in the investigation, which will include questionnaires and in-depth interviews. Cohorts of patients who have been newly diagnosed will be tracked to determine outcomes, and focus groups involving non-cancer patients will also be set up to assess attitudes towards help seeking and health care professionals.

The project is based on data from the North East Yorkshire and Humber Clinical Alliance which shows that cancer mortality rates in East Yorkshire are higher than the national average, and five year survival rates are significantly lower. The data also shows that deprived areas in East Yorkshire have higher mortality rates and lower survival rates compared to national rates.

Dr Macleod said: "Cancer patients in the UK are less likely to survive cancer than those in other parts of Europe, Canada and Australia, and survival is particularly bad in socio-economically poor areas such as East Yorkshire.

"We will carry out a number of related studies: understanding how cancers of the lung and head and neck first come to medical attention in patients who are socio-economically deprived; analysing cancer registry information relating to which part of the health service the patient first comes to with symptoms from their cancer; and investigating the reasons and outcomes for patients who first seek medical help with cancer as an emergency."

The second part of the project will evaluate palliative care services for those with advanced cancer. Data relating to referrals to and deaths in hospices will be analysed to determine inequalities depending on socio-economic background, age or gender, while patients with advanced cancer who are admitted to Hull Royal Infirmary for unscheduled care will be interviewed. Medical records will also be reviewed and focus groups involving specialists and GPs will be set up. A pilot scheme designed to improve the planning of care for advanced cancer patients will also be trialled at Hull Royal Infirmary.

Dr Macleod said: "Survival is not the only important issue – how people experience cancer and the care they receive is also very important for all patients, especially for those with advanced cancer. The purpose of this work is to ensure that all people with cancer, whether they are rich or poor, have high quality care. We hope that our research will lead to the earlier recognition of people with cancer, a reduction in the number of people diagnosed as an emergency, and the assessment of all advanced cancer patients to determine their needs so that they receive appropriate care in the most appropriate place."

The project will involve a collaboration between several researchers based at HYMS including Professor Miriam Johnson, Professor of Palliative Medicine, Dr Steven Oliver, Senior Lecturer in Public Health and Dr Victoria Allgar, Senior Lecturer in Medical Statistics.