One in three elderly cancer patients diagnosed only after an A&E visit with many tumours so advanced they are untreatable
07:01 GMT, 21 September 2012
One in three cancer sufferers over 70 is diagnosed only after they turn up in casualty, a major study has found.
In many cases, the patient’s tumours were so advanced by the time they sought help at an A&E department that they were untreatable.
Had the symptoms been picked up earlier – either by their GP or another specialist – their lives could have been spared, the researchers claimed.
Cancer survival rates in Britain are notoriously low compared with those in other European countries and experts believe late diagnosis is to blame. The Government has previously claimed that as many as 5,000 lives could be saved every year if the NHS improved its detection and treatment of cancer to the level of other nations.
There is widespread concern that an age bias exists across the NHS, with the elderly frequently denied the same standard of care as younger patients (posed by models)
Experts say the elderly are particularly vulnerable to late diagnosis, because they are more reluctant to see their GP when they are unwell.
And even when an appointment is made, doctors often find it harder to diagnose cancer in older patients as they may have a number of other health problems with confusing symptoms.
In the first study of its kind, researchers from the National Cancer Intelligence Network looked at data on 740,000 patients of all ages diagnosed with cancer between 2006 and 2008.
They specifically looked at where the illness had been diagnosed –whether via screening, in an appointment with a specialist or in A&E.
When the researchers included patients of all ages they found that one in four cancers were diagnosed in A&E units, but the rate increased to 31 per cent among the elderly.
Experts say the elderly are particularly vulnerable to late diagnosis as they are hesitant to go to the doctor (posed by models)
Some patients went to A&E because they were suffering very severe symptoms caused by the cancer such as pain, breathing difficulties or fitting.
But others just happened to have the cancers picked up after going to casualty with a broken hip or another entirely unrelated health problem.
Some had turned up in A&E of their own accord, while others had been referred by their GP.
Professor Mike Richards, the Government’s national cancer director who led the research, said: ‘This has come as a surprise to many people working in the field of cancer. It’s very important that we give equal access to care for people for all ages.
‘What we are trying to understand is whether they were patients who had been to their GP, but hadn’t been referred to hospital. Equally they may have been patients who never saw their GP. My hunch is that it’s partly one and partly the other.’
Professor Jane Maher, chief medical officer of Macmillan Cancer Support, said: ‘It is appalling that so many cancer patients are still diagnosed through emergency admissions. 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.’
The research, published in the British Journal of Cancer, also found that certain types of cancer, such as pancreatic, lung or brain, were far more likely to be picked up in A&E.
There is widespread concern that an age bias exists across the NHS, with the elderly frequently denied the same standard of care as younger patients. Professor Richards said that in this instance, he did not believe that the late diagnosis in the elderly was due to age discrimination. He said it was more likely due a ‘reluctance’ among this generation of patients to see their GP.
From the start of next month it will be illegal for healthcare professionals to deny patients treatment on the basis of their age.
A new law will enable patients to sue their doctors, nurses or entire hospitals if they think they have fallen victim to age discrimination by the NHS.