Introduction Incidence and mortality of all cancers combined in England are higher in individuals living within the most deprived areas compared to those from the least deprived. The government recognises that overall performance can be improved for people living in deprived areas. We analysed the effect of deprivation on the care pathway of patients with OG cancer.
Methods This study used data collected by the National Oesophago-Gastric Cancer audit (NOGCA) between April 2012 and March 2014 to evaluate the effect of social deprivation on the route of referral into secondary care and treatment options. Social deprivation was measured using the English Index of Multiple Deprivation, with patients allocated to quintiles based on the deprivation score for their area of residence. Quintile 1 represents the least deprived group and quintile 5 the most deprived. Analysis was performed using multivariable logistic regression.
Results 16,635 patients were included in the study with a mean age of 70.4 years and 69.2% males. The proportion of patients who were diagnosed after an emergency admission was 11.4% in the least deprived group and 16.4% in the most deprived group. An increase in a quintile of deprivation was associated with an 18% increase in risk of an emergency admission after adjusting for risk factors (age at diagnosis, sex, pre-treatment TNM stage, co-morbidities, site of tumour, and performance status), odds ratio (CI) 1.18 (1.1,13) p = 0.001. With every increase in the quintile of deprivation, there was a 8% decrease in likelihood of having curative surgery, odds ratio (CI) 0.92 (0.90,0.96) p < 0.001 after adjusting for route of referral and risk factors .
Conclusion The treatment pathway of patients with OG cancer differs among patients living in different areas of social deprivation, with most deprived patients being more likely to be diagnosed after an emergency admission and less likely to have curative surgery. The reasons for the variation needs to be investigated to improve overall outcomes.
Disclosure of Interest None Declared