Brain cancers in the elderly mostly diagnosed in A&E

 Over two-thirds of brain cancers, and a third of all cancers, in NHS patients aged over 70 are only diagnosed following emergency hospital admissions.

A study by the National Cancer Intelligence Network found that elderly patients made up two-thirds of the patients whose cancers were diagnosed by that route.

Importantly, it found that patients were far less likely to survive a year if their diagnosis came through A&E rather than an outpatient referral.

According to the study, which looked at 750,000 patients in England, 70% of brain cancers, 55% of pancreatic cancers and 52% of liver cancers in patients aged over 70 were diagnosed via emergency admissions in 2006–8.

Also, 39% of all lung cancers were only diagnosed after an A&E admission.

Study co-author Sara Hiom, Director of Information at Cancer Research UK, said: “We don’t yet know the reasons that lie behind these stark figures, but we urgently need to understand why there is such a great proportion.”

Possible explanations were that elderly patients were “reluctant to bother their doctor,” she said, or that doctors were dismissing symptoms as ‘old age’. In some cases the A&E admissions were emergency GP referrals.

According to Professor Sir Mike Richards, the National Cancer Director, improved awareness of the symptoms of hard-to-detect cancers could reduce the need for emergency diagnoses.

“A public awareness campaign run in Leeds showed that the proportion of emergency presentations can be reduced,” he noted. “Correspondingly more patients were diagnosed through the urgent outpatient route.”