Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis

Since 2011, we have been part of the twice awarded Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis funded by the NIHR Policy Research Programme. As one of the seven academic institutions that form the Policy Research Unit (PRU), led by Prof. Stephen Duffy at Queen Mary, University of London, we have been leading the research stream on cancer awareness and inequalities in cancer care and management.

In the first grant award (2011-2018) our research mainly focused on explaining the large proportion of cancers diagnosed through emergency presentation in England. We showed that general practice characteristics were not predictive of a high or low proportion of lung cancer emergency presentation (Maringe et al, 2018)  and that it was mostly due to patients by-passing primary care that increased the risk of an unplanned hospitalisation. Also, reducing hospital emergency admissions would require to identify the key reasons for the socioeconomic inequalities in emergency admissions that persisted even after controlling for the usual patient and tumour factors (Maringe et al, 2018). We also explored the roles of cancer symptom awareness and barriers to seeking medical help on cancer outcomes. Barriers clearly vary by socio-demographics and high barriers are associated with worse cancer outcomes (Niksic et al, 2015; Niksic et al, 2016; Niksic et al, 2016).

In this round of the programme (2019-2023), we aim to understand whether medical reasons for hospital admission in the two years prior to the cancer diagnosis are linked to the routes to cancer diagnosis. We will explore the interplay of diagnostic intensity and socioeconomic status, age and sex.  We will focus on prediction of emergency presentation based on the patient’s history in primary and secondary care.

ROBEST: Ensuring robustness of evidence in public health research for increased policy impact: widened use of advanced causal inference techniques