{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:49:48Z","timestamp":1791251388640,"version":"4.1.0"},"reference-count":24,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2018,8,31]]},"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Diagnosis of cancer through emergency presentation is associated with poorer prognosis. While reductions in emergency presentations have been described, whether known sociodemographic inequalities are changing is uncertain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We analysed \u2018Routes to Diagnosis\u2019 data on patients aged \u226525 years diagnosed in England during 2006\u20132013 with any of 33 common or rarer cancers. Using binary logistic regression we determined time-trends in diagnosis through emergency presentation by age, deprivation and cancer site.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall adjusted proportions of emergency presentations decreased during the study period (2006: 23%, 2013: 20%). Substantial baseline (2006) inequalities in emergency presentation risk by age and deprivation remained largely unchanged. There was evidence (p&lt;0.05) of reductions in the risk of emergency presentations for most (28\/33) cancer sites, without apparent associations between the size of reduction and baseline risk (p=0.26). If there had been modest reductions in age inequalities (ie, patients in each age group acquiring the same percentage of emergency presentations as the adjacent group with lower risk), in the last study year we could have expected around 11\u2009000 fewer diagnoses through emergency presentation (ie, a nationwide percentage of 16% rather than the observed 20%). For similarly modest reductions in deprivation inequalities, we could have expected around 3000 fewer (ie, 19%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The proportion of cancer diagnoses through emergency presentation is decreasing but age and deprivation inequalities prevail, indicating untapped opportunities for further improvements by reducing these inequalities. The observed reductions in proportions across nearly all cancer sites are likely to reflect both earlier help-seeking and improvements in diagnostic healthcare pathways, across both easier-to-suspect and harder-to-suspect cancers.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jech-2017-210371","type":"journal-article","created":{"date-parts":[[2018,11,9]],"date-time":"2018-11-09T07:09:52Z","timestamp":1541747392000},"page":"3-10","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Are inequalities in cancer diagnosis through emergency presentation narrowing, widening or remaining unchanged? Longitudinal analysis of English population-based data 2006\u20132013"],"prefix":"10.1136","volume":"73","author":[{"given":"Annie","family":"Herbert","sequence":"first","affiliation":[{"name":"ECHO (Epidemiology of Cancer Healthcare and Outcomes) Research Group, Department of Behavioural Sciences and Health, Institute of Epidemiology and Health Care, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2231-5161","authenticated-orcid":false,"given":"Gary A","family":"Abel","sequence":"additional","affiliation":[{"name":"University of Exeter Medical School (Primary Care), Exeter, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Winters","sequence":"additional","affiliation":[{"name":"National Cancer Registration and Analysis Service (NCRAS), Public Health England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"McPhail","sequence":"additional","affiliation":[{"name":"National Cancer Registration and Analysis Service (NCRAS), Public Health England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Elliss-Brookes","sequence":"additional","affiliation":[{"name":"National Cancer Registration and Analysis Service (NCRAS), Public Health England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Lyratzopoulos","sequence":"additional","affiliation":[{"name":"ECHO (Epidemiology of Cancer Healthcare and Outcomes) Research Group, Department of Behavioural Sciences and Health, Institute of Epidemiology and Health Care, University College London, London, UK"},{"name":"National Cancer Registration and Analysis Service (NCRAS), Public Health England, London, UK"},{"name":"THIS (The Health Improvement Studies) Institute, and Cambridge Centre for Health Services Research, University of Cambridge, Institute of Public Health, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,11,8]]},"reference":[{"key":"2025100702482709000_73.1.3.1","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1038\/nrclinonc.2016.155","article-title":"Diagnosis of cancer as an emergency: a critical review of current evidence","volume":"14","author":"Zhou","year":"2017","journal-title":"Nat Rev Clin Oncol"},{"key":"2025100702482709000_73.1.3.2","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2012.408"},{"key":"2025100702482709000_73.1.3.3","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2013.569"},{"key":"2025100702482709000_73.1.3.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2013.04.004"},{"key":"2025100702482709000_73.1.3.5","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2407-14-927","article-title":"Missed opportunities: racial and neighborhood socioeconomic disparities in emergency colorectal cancer diagnosis and surgery","volume":"14","author":"Pruitt","year":"2014","journal-title":"BMC Cancer"},{"key":"2025100702482709000_73.1.3.6","unstructured":"National Cancer Registration and Analysis Service. 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