Cancers of the female reproductive system (i.e., cervical, ovarian, uterine, vaginal and vulval or summarised as gynaecological cancers) can affect many women despite some of them being not very common. Previous research suggests that there are differences in who attends screening, how quickly their cancer is diagnosed, and how the cancer is treated, amongst different ethnic groups and for people who live in more deprived areas.
We will explore differences in diagnosing and treating gynaecological cancers by age, ethnicity, and deprivation. We will use linked primary care and hospital data to look at differences in how often each cancer type gets diagnosed, how severe the cancer is when it is diagnosed, how long patients wait for their diagnosis after showing symptoms, how long they wait for their treatment after first diagnosis, and death.
Understanding differences in diagnosis and treatment of gynaecological cancer can help to improve access to healthcare for people who might have experienced difficulties getting care or who are at high risk of more severe outcomes.
Gynaecological cancer is a collective term for cervical, ovarian, uterine, vaginal and vulval cancers with an incidence of more than 18,000 cases in England every year. Previous studies have suggested that there might be differences in screening attendance, number of diagnoses, cancer stage at diagnosis, access to treatment, and outcomes for different ethnic groups or by socioeconomic status. However, these studies have mainly been focused on endometrial, cervical, or ovarian cancer individually, and very few studies are in a UK healthcare setting.
For this study, we will use the Clinical Practice Research Datalink (CPRD) Aurum and linked Hospital Episodes Statistics, Office for National Statistics deaths registrations, and Index of Multiple Deprivation data to explore health inequalities in all types of gynaecological cancers by age, ethnicity, and socioeconomic status. We will describe differences in incidence, cancer stage at diagnosis, time-to-diagnosis, time-to-treatment, and survival. Furthermore, we will perform Poisson regression and survival analyses using Cox proportional hazards regression to test for these differences between ethnicities, age groups and levels of deprivation.
Understanding inequalities in diagnosing and treating gynaecological cancer can help to inform health policy to improve access to healthcare across different groups of the population, e.g., by improving access to screening and encouraging uptake, which then could improve times to treatment and survival of different patients in the long term.
- Incidence of each cervical, ovarian, uterine, vaginal, and vulval cancer
- Cancer stage at first diagnosis for each cervical, ovarian, uterine, vaginal, and vulval cancer
- Patient pathway for diagnosis of each cervical, ovarian, uterine, vaginal, and vulval cancer
- Time from symptom to diagnosis for each cervical, ovarian, uterine, vaginal, and vulval cancer
- Time from diagnosis to treatment for each cervical, ovarian, uterine, vaginal, and vulval cancer
- 1-, 2- and 5-year survival rate for each cervical, ovarian, uterine, vaginal, and vulval cancer
Jennifer Davidson - Chief Investigator - Health iQ Ltd ( UK ) t/a CorEvitas
Caitlin Winton - Corresponding Applicant - Health iQ Ltd ( UK ) t/a CorEvitas
Caoimhe Rice - Collaborator - Health iQ Ltd ( UK ) t/a CorEvitas
Hannah Brewer - Collaborator - Health iQ Ltd ( UK ) t/a CorEvitas
James Baird - Collaborator - Health iQ Ltd ( UK ) t/a CorEvitas
Mico Hamlyn - Collaborator - Health iQ Ltd ( UK ) t/a CorEvitas
Sara Carvalho - Collaborator - Health iQ Ltd ( UK ) t/a CorEvitas
Hannah Brewer - Collaborator - Health iQ Ltd ( UK ) t/a CorEvitas
James Baird - Collaborator - Health iQ Ltd ( UK ) t/a CorEvitas
Sara Carvalho - Collaborator - Health iQ Ltd ( UK ) t/a CorEvitas
HES Accident and Emergency;HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation