Multiple myeloma: routes to diagnosis, clinical characteristics and survival - findings from a UK population-based study.
Prompt cancer diagnosis may align UK survival with European averages. We examined the impact of route to diagnosis on survival for multiple myeloma patients diagnosed 2012-2013 using data from our population-based patient cohort that links to national death notifications and collects details on treatment and response (n = 441). Emergency presentation was associated with advanced disease and poorer outcomes, and was the commonest route to diagnosis (28·1%) followed by General Practitioner urgent (19·0%) and two-week wait (17·2%) referrals. CRAB (elevated Calcium, Renal failure, Anaemia, Bone lesions) distribution varied by route (P < 0·001), with patients with emergency presentations most likely to have ≥2 features and significantly worse survival (log-rank test χ2= 13·8, P = 0·0002).
Epidemiology & Cancer Statistics Group, Department of Health Sciences, University of York, York, UK.
Debra
D
Howell
Epidemiology & Cancer Statistics Group, Department of Health Sciences, University of York, York, UK.
Alexandra
A
Smith
Epidemiology & Cancer Statistics Group, Department of Health Sciences, University of York, York, UK.
Simon
S
Appleton
Epidemiology & Cancer Statistics Group, Department of Health Sciences, University of York, York, UK.
Timothy
T
Bagguley
Centre for Health and Population Sciences, University of Hull, Hull, UK.
Una
U
Macleod
Department of Haematology, St James's University Hospital, Leeds, UK.
Gordon
G
Cook
Queen's Centre for Oncology and Haematology, Castle Hill Hospital, Cottingham, UK.
Russell
R
Patmore
Epidemiology & Cancer Statistics Group, Department of Health Sciences, University of York, York, UK.
Eve
E
Roman
D000368:Aged; D000369:Aged, 80 and over; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy; D017063:Outcome Assessment, Health Care; D010641:Phenotype; D011159:Population Surveillance; D006113:United Kingdom / Q000453:epidemiology
clinical characteristics; emergency presentation; multiple myeloma; route to diagnosis; survival