ArticleBMJ open2013
Impact of route to diagnosis on treatment intent and 1-year survival in patients diagnosed with oesophagogastric cancer in England: a prospective cohort study.
Article in BMJ open, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Pooled it
- Diagnostic delay as health system navigation: a mixed-methods study of childhood cancer in Burkina Faso.BMC cancer · 2026Article
- A digital quality measure for emergency presentation of pancreatic cancer.British journal of cancer · 2026Article
- Inequalities in cancer diagnostic outcomes for patients with a learning disability: a retrospective cohort study in England.BMJ oncology · 2026Article
- Emergency department use before cancer diagnosis in Ontario, Canada: a population-based study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Article
- Assessing how routes to diagnosis vary by the age of patients with cancer: a nationwide register-based cohort study in Denmark.BMC cancer · 2022Article
- Patient experiences of the urgent cancer referral pathway-Can the NHS do better? Semi-structured interviews with patients with upper gastrointestinal cancer.Health expectations : an international journal of public participation in health care and health policy · 2020Article
- Prognostic consequences of implementing cancer patient pathways in Denmark: a comparative cohort study of symptomatic cancer patients in primary care.BMC cancer · 2017Article
- Diagnosis of cancer as an emergency: a critical review of current evidence.Nature reviews. Clinical oncology · 2017Review
- The current role of staging laparoscopy in oesophagogastric cancer.Annals of the Royal College of Surgeons of England · 2015Article
- Minimally invasive esophagectomy for dysplastic Barrett's esophagus.World journal of surgery · 2015Review
- Cancer diagnosed by emergency admission in England: an observational study using the general practice research database.BMC health services research · 2013Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate the relationship between the route to diagnosis, patient characteristics, treatment intent and 1 -year survival among patients with oesophagogastric (O-G) cancer.
settingCohort study in 142 English NHS trusts and 30 cancer networks.
participantsPatients diagnosed with O-G cancer between October 2007 and June 2009.
designProspective cohort study. Route to diagnosis defined as general practitioner (GP) referral-urgent (suspected cancer) or non-urgent, hospital consultant referral, or after an emergency admission. Logistic regression was used to estimate associations and adjust for differences in casemix.
main outcome measuresProportion of patients diagnosed by route of diagnosis; proportion of patients selected for curative treatment; 1-year survival.
resultsAmong 14 102 cancer patients, 66.3% were diagnosed after a GP referral, 16.4% after an emergency admission and 17.4% after a hospital consultant referral. Of the 9351 GP referrals, 68.8% were urgent. Compared to urgent GP referrals, a markedly lower proportion of patients diagnosed after emergency admission had a curative treatment plan (36% vs 16%; adjusted OR=0.62, 95% CI 0.52 to 0.74) and a lower proportion survived 1 year (43% vs 27%; OR 0.78; 95% CI 0.68 to 0.89). Urgency of GP referral did not affect treatment intent or survival. Routes to diagnosis varied across cancer networks, with the adjusted proportion of patients diagnosed after emergency admission ranging from 8.7 to 32.3%.
conclusionsOutcomes for cancer patients are worse if diagnosed after emergency admission. Primary care and hospital services should work together to reduce rates of diagnosis after emergency admission and the variation across cancer networks.
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