Source: Annual Congress 2009 - Epidemiology and management of lung cancer

Abstract

Introduction
Deprivation is linked to lung cancer. There is regional variation in deprivation, but also variation on a local level. Resource allocation does not currently recognise this.
We hypothesise that GP practices with more deprived populations have higher rates of referral to the lung cancer service, and higher lung cancer rates overall.
Method
All GP referrals to our unit over a 3 ½ year period were identified from the lung cancer database and grouped via practice, along with all referrals deemed inappropriate. A lung cancer rate and rankings for the Index of Multiple Deprivation (IMD) and health deprivation (HD) were obtained for each practice.
Results
1182 referrals were received, and 168 (14%) were deemed inappropriate by a consultant chest physician. The overall lung cancer rate was 38%, but 44.2% when the inappropriate referrals were removed. Practice IMD or HD rank did not predict referral volume overall, but practices with a higher rate of inappropriate referral had a more deprived ranking (p=0.04). Practice lung cancer rate was associated with higher IMD (p=0.04) and HD (p=0.02) ranking, and also correlated with inappropriate referral volume (p=0.003).
Discussion
GP practices in more deprived areas have a higher lung cancer rate per head of population, but also refer more patients inappropriately to the lung cancer service. It may be appropriate to reallocate resources according to the deprivation ranking of the GP practice. Close attention should be paid to these referrals, and efforts should be made to educate staff regarding referral criteria, as inappropriate use may place pressures on the service, delay patients who need to be seen and cause anxiety and distress in those who are wrongly referred.

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Citations should be made in the following way:
J. Greenwood, A. Ponnuswamy, V. Sreeguru Lakshman, M. Ledson, M. Walshaw (Liverpool, United Kingdom). Deprivation and referrals to a rapid access lung cancer service. Eur Respir J 2009; 34: Suppl. 53, 4685

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