ArticleThorax2015
What characteristics of primary care and patients are associated with early death in patients with lung cancer in the UK?
Article in Thorax, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Lung cancer in symptomatic patients presenting in primary care: a systematic review of risk prediction tools.The British journal of general practice : the journal of the Royal College of General Practitioners · 2017Pooled it
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- Trial
- Routes to Diagnosis in Lung Cancer-Do Socio-Demographics Matter? An English Population-Based Study.Cancers · 2025Article
- Smoking status, symptom significance and healthcare seeking with lung cancer symptoms in the Danish general population.NPJ primary care respiratory medicine · 2025Article
- The incidence of lung cancer amongst primary care chest radiograph referrals-an evaluation of national and local datasets within the United Kingdom.The British journal of radiology · 2024Article
- Risk factors for early mortality from lung cancer: evolution over the last 20 years in the French nationwide KBP cohorts.ESMO open · 2024Observational
- Early mortality in German patients with lung cancer: risk factors associated with 30-and 60-day mortality.Clinical and experimental medicine · 2023Article
- How do the UK's guidelines on imaging for suspected lung cancer compare with other countries?The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Article
- Risk factors for early mortality of lung cancer patients in France: A nationwide analysis.Cancer medicine · 2022Article
- Increasing uptake to a lung cancer screening programme: building with communities through co-design.BMC public health · 2022Article
- Associations between general practice characteristics and chest X-ray rate: an observational study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Observational
- Lung cancer for the non-respiratory physician.Clinical medicine (London, England) · 2021Review
- Treatment Patterns Among De Novo Metastatic Cancer Patients Who Died Within 1 Month of Diagnosis.JNCI cancer spectrum · 2019Article
- Presentation of lung cancer in primary care.NPJ primary care respiratory medicine · 2019Article
- Achieving Thoracic Oncology data collection in Europe: a precursor study in 35 Countries.BMC cancer · 2018Article
- Increasing radiology capacity within the lung cancer pathway: centralised work-based support for trainee chest X-ray reporting radiographers.Journal of medical radiation sciences · 2018Article
- Geographical variations in the use of cancer treatments are associated with survival of lung cancer patients.Thorax · 2018Article
- Immediate reporting of chest X-rays referred from general practice by reporting radiographers: a single centre feasibility study.Clinical radiology · 2018Article
- Recent advances in the management of lung cancer.Clinical medicine (London, England) · 2018Review
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8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe UK has poor lung cancer survival rates and high early mortality, compared to other countries. We aimed to identify factors associated with early death, and features of primary care that might contribute to late diagnosis.
methodsAll cases of lung cancer diagnosed between 2000 and 2013 were extracted from The Health Improvement Network database. Patients who died within 90 days of diagnosis were compared with those who survived longer. Standardised chest X-ray (CXR) and lung cancer rates were calculated for each practice.
resultsOf 20,142 people with lung cancer, those who died early consulted with primary care more frequently prediagnosis. Individual factors associated with early death were male sex (OR 1.17; 95% CI 1.10 to 1.24), current smoking (OR 1.43; 95% CI 1.28 to 1.61), increasing age (OR 1.80; 95% CI 1.62 to 1.99 for age ≥80 years compared to 65-69 years), social deprivation (OR 1.16; 95% CI 1.04 to 1.30 for Townsend quintile 5 vs 1) and rural versus urban residence (OR 1.22; 95% CI 1.06 to 1.41). CXR rates varied widely, and the odds of early death were highest in the practices which requested more CXRs. Lung cancer incidence at practice level did not affect early deaths.
conclusionsPatients who die early from lung cancer are interacting with primary care prediagnosis, suggesting potentially missed opportunities to identify them earlier. A general increase in CXR requests may not improve survival; rather, a more timely and appropriate targeting of this investigation using risk assessment tools needs further assessment.
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