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

Publication date: Available online 23 May 2019Source: Journal of Cancer PolicyAuthor(s): Steve Langton, Derek Lowe, Simon N Rogers, Annette Plüddemann, Clare BankheadAbstractBackgroundThe ‘two-week rule’ (TWR) fast-track cancer referral system for head and neck cancers was introduced by the UK government in 2000, to facilitate earlier diagnosis. However, little work has compared stage on diagnosis of cancer before and after the implementation of the system.Objectives•Describe the presentation of oral cancer in Merseyside from 1992-2012.•To evaluate whether stage on presentation has improved after the introduction of the TWR using data from a clinical database in Merseyside 1992-2012.•To assess the relationship between stage on presentation and social deprivation 1992-2012.•To assess the change in presentation for different sites within the oral cavity.Method and settingPatients were identified using the Aintree (Liverpool) head and neck oncology database, containing all diagnoses of oral squamous cell carcinoma (SCC) between 1992 – 2012. Cancers were clinically staged using the American Joint Committee on Cancer (AJCC) stage groupings and divided into ‘early’ (stage 1 and 2) and ‘late’ (stage 3 and 4). Index of Multiple Deprivation (IMD) 2004 data were derived from patient postcodes. Appropriate regression analyses were undertaken.Results1485 consecutive patients diagnosed were studied. Median (IQR) age was 63 (55-73) years and 61% were male. 36% of can...
Source: Journal of Cancer Policy - Category: Cancer & Oncology Source Type: research