title: Variation in advanced stage at diagnosis of lung and female breast cancer in an English region 2006-2009.
abstract: BACKGROUND
  Understanding variation in stage at diagnosis can inform interventions to improve the timeliness of diagnosis for patients with different cancers and characteristics.
  
  
  METHODS
  We analysed population-based data on 17,836 and 13,286 East of England residents diagnosed with (female) breast and lung cancer during 2006-2009, with stage information on 16,460 (92%) and 10,435 (79%) patients, respectively. Odds ratios (ORs) of advanced stage at diagnosis adjusted for patient and tumour characteristics were derived using logistic regression.
  
  
  RESULTS
  We present adjusted ORs of diagnosis in stages III/IV compared with diagnosis in stages I/II. For breast cancer, the frequency of advanced stage at diagnosis increased stepwise among old women (ORs: 1.21, 1.46, 1.68 and 1.78 for women aged 70-74, 75-79, 80-84 and ≥85, respectively, compared with those aged 65-69 , P<0.001). In contrast, for lung cancer advanced stage at diagnosis was less frequent in old patients (ORs: 0.82, 0.74, 0.73 and 0.66, P<0.001). Advanced stage at diagnosis was more frequent in more deprived women with breast cancer (OR: 1.23 for most compared with least deprived, P=0.002), and in men with lung cancer (OR: 1.14, P=0.011). The observed patterns were robust to sensitivity analyses approaches for handling missing stage data under different assumptions.
  
  
  CONCLUSIONS
  Interventions to help improve the timeliness of diagnosis of different cancers should be targeted at specific age groups.
authors.affiliation: Department of Public Health and Primary Care, Cambridge Centre for Health Services Research, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0SR, UK. gl290@medschl.cam.ac.uk
authors.forename: G
authors.initials: G
authors.lastname: Lyratzopoulos
authors.forename: G A
authors.initials: GA
authors.lastname: Abel
authors.forename: J M
authors.initials: JM
authors.lastname: Barbiere
authors.forename: C H
authors.initials: CH
authors.lastname: Brown
authors.forename: B A
authors.initials: BA
authors.lastname: Rous
authors.forename: D C
authors.initials: DC
authors.lastname: Greenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology*; D055088:Early Detection of Cancer; D004739:England; D005260:Female; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016017:Odds Ratio; D012959:Socioeconomic Factors; D055815:Young Adult