Abstract:
BACKGROUND:Diagnosis of cancer through emergency presentation is associated with poorer prognosis. While reductions in emergency presentations have been described, whether known sociodemographic inequalities are changing is uncertain. METHODS:We analysed 'Routes to Diagnosis' data on patients aged ≥25 years diagnosed in England during 2006-2013 with any of 33 common or rarer cancers. Using binary logistic regression we determined time-trends in diagnosis through emergency presentation by age, deprivation and cancer site. RESULTS:Overall adjusted proportions of emergency presentations decreased during the study period (2006: 23%, 2013: 20%). Substantial baseline (2006) inequalities in emergency presentation risk by age and deprivation remained largely unchanged. There was evidence (p<0.05) of reductions in the risk of emergency presentations for most (28/33) cancer sites, without apparent associations between the size of reduction and baseline risk (p=0.26). If there had been modest reductions in age inequalities (ie, patients in each age group acquiring the same percentage of emergency presentations as the adjacent group with lower risk), in the last study year we could have expected around 11 000 fewer diagnoses through emergency presentation (ie, a nationwide percentage of 16% rather than the observed 20%). For similarly modest reductions in deprivation inequalities, we could have expected around 3000 fewer (ie, 19%). CONCLUSION:The proportion of cancer diagnoses through emergency presentation is decreasing but age and deprivation inequalities prevail, indicating untapped opportunities for further improvements by reducing these inequalities. The observed reductions in proportions across nearly all cancer sites are likely to reflect both earlier help-seeking and improvements in diagnostic healthcare pathways, across both easier-to-suspect and harder-to-suspect cancers.
journal_name
J Epidemiol Community Healthjournal_title
Journal of epidemiology and community healthauthors
Herbert A,Abel GA,Winters S,McPhail S,Elliss-Brookes L,Lyratzopoulos Gdoi
10.1136/jech-2017-210371subject
Has Abstractpub_date
2019-01-01 00:00:00pages
3-10issue
1eissn
0143-005Xissn
1470-2738pii
jech-2017-210371journal_volume
73pub_type
杂志文章,评审abstract:BACKGROUND:Social inequality in ischaemic heart disease has been related to socioeconomic position in childhood, early adulthood and late adulthood. However, the impact of relative level of accumulated income periods across adult life course and the potential gender and age differences have not been investigated. The a...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2018-212043
更新日期:2019-09-01 00:00:00
abstract::A study of 150 hotel prostitutes in Lagos was undertaken to determine their socioeconomic identity and, through an assessment of their health knowledge, attitude, and practice, their probable impact on public health. The subjects were selected from 15 hotels, representing 20% of the estimated hotel universe in Lagos a...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.34.4.312
更新日期:1980-12-01 00:00:00
abstract:STUDY OBJECTIVE:The aim was to report on the extent to which death certificates which specify that death occurred in hospital can be matched and linked with routine hospital inpatient information systems. DESIGN:The study involved linkage of hospital records which specified that death occurred in hospital to correspon...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.46.3.297
更新日期:1992-06-01 00:00:00
abstract::A retrospective questionnaire and interview study of 10 year survivors of uncomplicated myocardial infarction examined smoking, diet, exercise, weight, medication, and treatment since discharge from hospital in 1973-4 and made comparisons with controls (using the same questionnaire) and with normal populations (as rep...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.40.2.103
更新日期:1986-06-01 00:00:00
abstract:BACKGROUND:Previous studies show contradictory findings on the relationship between health and intergenerational living arrangements (ILAs), which may be due to variation in who selects themselves into and out of ILA. Addressing the selectivity into ILA and the health of the older generation, we assess whether there is...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2017-209896
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:This study investigates social inequalities in self-rated health dynamics for working-aged adults in four nations, representing distinct welfare regime types. The aims are to describe average national trajectories of self-rated health over a 7-year period, identify social determinants of cross-sectional and ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2009.091199
更新日期:2011-02-01 00:00:00
abstract:STUDY OBJECTIVE:The main cause of breast cancer remains unknown. Numerous causal factors or predisposing conditions have been proposed, but account for only a small percentage of the total disease. The current search for multiple causes is unavailing. This report explores whether any single aetiological agent may be re...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,评审
doi:10.1136/jech.54.11.851
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:Spain has recently become an inward migration country. Little is known about the occupational health of immigrant workers. This study aimed to explore the perceptions that immigrant workers in Spain had of their working conditions. METHODS:Qualitative, exploratory, descriptive study. Criterion sampling. Dat...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2008.077016
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVES:To establish the prevalence and distribution of witnesses, victims, and perpetrators of different types of violence in the general population and the proportion of victims consulting health services or reporting the incident to authorities. METHODS:Cross sectional survey of a random sample of 3007 inhabitan...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.57.5.355
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:Housing is an important environmental influence on population health, and there is growing evidence of health effects from indoor environment characteristics such as low indoor temperatures. However, there is relatively little research, and thus little firm guidance, on the cost-effectiveness of public polic...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,随机对照试验
doi:10.1136/jech.2007.070037
更新日期:2009-04-01 00:00:00
abstract:STUDY OBJECTIVES:To analyse the factors that determined whether or not people were successful in quitting tobacco during the 1980s in Sweden. DESIGN:A logistic regression model was used for the analyses and included: education, marital status, socioeconomic group, social network, physical activities, cigarette consump...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.50.6.625
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:There is concern that increasing demand for student mental health services reflects deteriorating student well-being. We designed a pragmatic, parallel, single-blinded randomised controlled trial hypothesising that providing mindfulness courses to university students would promote their resilience to stress ...
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pub_type: 杂志文章
doi:10.1136/jech-2020-214390
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND:Although trouble sleeping is a common problem among women at mid-life, patterns in trouble sleeping relating to social and health-related risk factors are unclear. This analysis describes the dynamics of trouble sleeping among women at mid-life. METHODS:The National Survey of Health and Development is a nat...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,多中心研究
doi:10.1136/jech.2008.079616
更新日期:2009-12-01 00:00:00
abstract::It is not a point of debate that the Stockholm Convention for the prevention of further accumulation of persistent organic pollutants (POPs) should be ratified and implemented by all countries. However, in their article, Schafer and Kegley present an unbalanced "worst case scenario". Approximately 20% of the food supp...
journal_title:Journal of epidemiology and community health
pub_type: 评论,杂志文章
doi:10.1136/jech.56.11.824
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:In the context of fiscal austerity in many European welfare states, policy innovation often takes the form of 'social investment', a contested set of policies aimed at strengthening labour markets. Social investment policies include employment subsidies, skills training and job-finding services, early childh...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2018-211283
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVE:To examine factors associated with returning for second round mammography screening. SETTING:This was a population based mammographic screening programme in Melbourne, Australia. DESIGN:A cohort design was used whereby 668 women were interviewed before the screening programme began and attendance for both f...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.51.1.62
更新日期:1997-02-01 00:00:00
abstract::It has been claimed that unemployment affects the health and thus the mortality of the unemployed, their families, and other members of their communities. This paper examines the relation between mortality and the unemployment experiences of small areas which vary in the extent to which their unemployment levels have ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.41.2.107
更新日期:1987-06-01 00:00:00
abstract:STUDY OBJECTIVE:To explore the role of history in public health and its relevance to current practice and professional development. DESIGN:An analysis of the issues surrounding the poor attention paid to the history of public health by its current practitioners. SETTING:The paper is written from the perspective of pr...
journal_title:Journal of epidemiology and community health
pub_type: 历史文章,杂志文章
doi:10.1136/jech.2003.014340
更新日期:2004-09-01 00:00:00
abstract::Numerous commentaries plea for the use of methods that take into account complexity when evaluating health programmes. These commentaries provide compelling arguments on why evaluations of health programmes should not rely exclusively on methods that were designed for making universal claims about whether and to what ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2020-214027
更新日期:2021-01-01 00:00:00
abstract::Over 300 female farmers from 18 regions in various parts of Japan were examined for high density lipoprotein cholesterol (HDL) in the serum. Based on the HDL levels, three examinees with the highest HDL and another three with the lowest HDL were selected from each region to form the high HDL group (high group, 54 subj...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.39.3.259
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abstract:BACKGROUND:China has been facing nationwide air pollution at unprecedented high levels primarily from fossil-fuel combustion in the past decade. However, few studies have been conducted on the adverse effect of severe air pollution on lung development in school-age children. METHODS:Using wellness check and air pollut...
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pub_type: 杂志文章
doi:10.1136/jech-2020-214283
更新日期:2020-10-01 00:00:00
abstract::From 1969 to the end of 1983 in Norway, dementia was coded as the underlying cause of death from 2058 death certificates, and as a contributory cause from 19,459. This is 3.56% of the total number of deaths. It seems that a considerable proportion of dementia cases are noted on death certificates in Norway. Death rate...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.43.3.285
更新日期:1989-09-01 00:00:00
abstract:BACKGROUND:Age-specific death from cardiovascular disease among Australian Aboriginals is estimated to be four to seven times that of general population, and the major cause of premature death. There is little reliable information on the incidence of coronary heart disease (CHD). This study compares CHD event rates in ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2009.098343
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Efforts to end preventable newborn deaths will fail if the poor are not reached with effective interventions. To understand what works to reach vulnerable groups, we describe and explain the uptake of a highly effective community-based newborn health intervention across social strata in Asia and Africa. MET...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2014-204685
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:To investigate diagnosis-specific sick leave as a risk marker for subsequent disability pension. DESIGN:A prospective population based cohort study. Exposure to a new medically certified sick leave episode of more than seven days by diagnosis during 1985 was examined in relation to incident cause-specific di...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2006.055426
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:To elucidate whether the risk of macrosomia, large for gestational age (LGA) and small for gestational age (SGA) is influenced by maternal body mass index and glucose tolerance differently in male and female fetuses. METHODS:A population study was conducted in 16 general hospitals from the Spanish National H...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,多中心研究
doi:10.1136/jech.2008.074542
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:Differences in health, lifestyles, and use of health care between groups of varying ethnic origin can have important implications for preventive and curative health care. This paper studies whether socioeconomic factors explain ethnic differences in these outcomes. DESIGN:Data on health status, lifestyles, a...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.52.5.298
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:Metabolic syndrome (MS) has an increased risk for developing cardiovascular disease (CVD); however, whether the concept of MS, applying the new joint interim statement definition, has a greater impact on incident CVD than its individual components is debated. METHODS:The authors related MS and its component...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2010.117697
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:To compare common health experiences of a South Asian (predominantly Punjabi) population with that of the general population, according to sex, and to related patterns of health in the fourth decade of life to the pattern of hospital admission and mortality documented in the published reports. DESIGN AND SET...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.47.2.96
更新日期:1993-04-01 00:00:00
abstract:STUDY OBJECTIVE:The aim was to assess the differences in suicide data obtained from different database sources. DESIGN:Death certificate based data on suicidal deaths were compared with the information obtained from the non-natural death investigation files at the Public Prosecutor's Office. SETTING:The study was con...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.47.1.73
更新日期:1993-02-01 00:00:00