Socio-economic factors influence whether rectal cancer patients have an emergency or planned admission

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Research just published by researchers working with the National Cancer Registry has shown that social and economic factors were important in determining if patients with rectal cancer were first admitted to hospital as an emergency, and that emergency admission was one of the strongest predictors of poor survival.

This study, of 2750 patients diagnosed with rectal cancer in 2004-2008, was funded by the Irish Cancer Society, and showed that 12% of patients attended hospital first with their cancer as an emergency. Married or younger patients, those with private health insurance and those living in more affluent areas were less likely to be seen as an emergency and, partly as a result of this, patients in these groups had better survival. Patients presenting as an emergency were less likely to receive optimal treatment or to be treated in a hospital which dealt with higher than average numbers of rectal cancers.

Only 6% of private patients in the most affluent areas were seen first as an emergency, compared with 20% of public patients in the most deprived areas, so socio-economic factors seem to be important in influencing whether patients have an emergency or planned admission. Whether this is due to patient factors, health system factors, or both, is something which requires more research. This should focus in more detail on the specific decisions and pathways which decide whether a patient with cancer is seen for the first time as an emergency or as a planned outpatient. However, it is clear that some emergency admissions, and the consequent poor survival, are potentially avoidable.

The study has been published in the International Journal of Cancer.

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