People with cancer living in deprived areas of Wales are more likely to have another serious illness or disorder at diagnosis than those in the least deprived areas, according to new research by Macmillan Cancer Support and Public Health Wales’ Welsh Cancer Intelligence and Surveillance Unit.
This could make it more difficult for NHS services to diagnose cancer early in these patients, as well as present challenges for services that plan and deliver cancer treatment.
The research, the first of its kind in Wales, and believed to be the first of its kind in the UK, reveals at least one in four people diagnosed with cancer in Wales between 2011 and 2015 were already living with another serious disorder or illness such as diabetes, dementia, and heart failure.
And people with cancer are less likely to survive for a year following their diagnosis as the severity of or number of their existing illness or illnesses increases.
This research reveals the challenges facing the NHS in diagnosing cancer early, as existing conditions and illnesses may hide cancer symptoms.
It also highlights how many people with cancer have other conditions or illnesses to manage at diagnosis, which poses further challenges to the NHS when planning and giving cancer treatment.
The new research shows men are more likely to have an existing condition at diagnosis than women.
It also highlights variation in the number of people with existing illnesses according to the type of cancer they have.
Around a quarter of people with bowel cancer had a significant illness or condition at diagnosis whereas 90 per cent of women with breast cancer and just over 80 per cent of men with prostate cancer did not have an illness considered as part of this research when diagnosed.
In contrast, people with lung cancer were more likely to have an existing illness at diagnosis compared to people with other cancer types.
Out of the illnesses and disorders analysed, men living with and beyond cancer were most likely to have diabetes whereas women living with and beyond cancer were more likely to have respiratory illness.
People with cancer who also had dementia had the lowest one-year survival rate. However, this could be because people with dementia tend to be older.
Richard Pugh, Head of Services (Wales) for Macmillan Cancer Support said:
“This in-depth research shows for the first time that people with cancer in Wales living in deprived areas are more likely to have an existing serious illness at diagnosis than people living in our least deprived areas.
“Macmillan wants people with cancer to live their lives as fully as they can so we hope this research highlights how many people are living with another condition or illnesses at diagnosis to health professionals and those planning cancer care.
“Macmillan wants each person with cancer to be cared for as a whole person and to receive high quality cancer treatment which enables their existing illnesses to be managed well.
“We’d also encourage people with existing illnesses not to dismiss any new or worsening symptoms and to visit their GP for advice.”
Dr Ciarán Humphreys from Public Health Wales said: “This research shows that cancer patients who had no other long-term conditions had better outcomes than those who had other serious illnesses.
“Being physically active, not smoking, drinking less alcohol and eating nutritious food are all ways of reducing the risk of developing cancer and other long-term conditions, and improving outcomes for those who are diagnosed.
“GPs and local planners can now access this data through a flexible, on line tool, to support them in better understanding the needs of their local population”.
The research looked at Welsh residents registered with a GP and analysed incidence and prevalence for all cancers (excluding non-melanoma skin cancer), and common cancers (lung, colorectal, prostate and female breast cancer).
One-year survival was also calculated for all Welsh residents diagnosed between 2011 and 2014 for the above cancer types.
Where possible, the analysis was broken down by GP cluster network, age, gender, how advanced the cancer was at diagnosis, deprivation and rurality.
It considered conditions recorded in the twelve months prior to cancer diagnosis.
The data was analysed using the Charlson Comorbidity Index, which is a validated tool used by healthcare professionals to predict risk of death and the burden of a disease.
Starting at zero, a patient’s score can increase because of how severe their illness or illnesses are or because of the number of conditions they have.
This work uses information collected by the NHS as part of providing patient care and support.