Variation in advanced stage at diagnosis of lung and female breast cancer in an English region 2006-2009

Br J Cancer. 2012 Mar 13;106(6):1068-75. doi: 10.1038/bjc.2012.30. Epub 2012 Mar 1.


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.

Conclusion: Interventions to help improve the timeliness of diagnosis of different cancers should be targeted at specific age groups.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / pathology*
  • Early Detection of Cancer
  • England
  • Female
  • Humans
  • Logistic Models
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / pathology*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Odds Ratio
  • Socioeconomic Factors
  • Young Adult