TY - JOUR
T1 - The distribution of lung cancer across sectors of society in the United Kingdom
T2 - A study using national primary care data
AU - Iyen-Omofoman, Barbara
AU - Hubbard, Richard B.
AU - Smith, Chris J.P.
AU - Sparks, Emily
AU - Bradley, Emma
AU - Bourke, Alison
AU - Tata, Laila J.
N1 - Funding Information:
The authors would like to thank Professor Henrik Møller of the Thames Cancer Registry for providing data on lung cancer incidence across the UK strategic health authorities 2003-2007. This research was funded by a PhD studentship from the Economic and Social Research Council, held by Barbara Iyen-Omofoman.
PY - 2011
Y1 - 2011
N2 - Background: There is pressing need to diagnose lung cancer earlier in the United Kingdom (UK) and it is likely that research using computerised general practice records will help this process. Linkage of these records to area-level geo-demographic classifications may also facilitate case ascertainment for public health programmes, however, there have as yet been no extensive studies of data validity for such purposes. Methods. To first address the need for validation, we assessed the completeness and representativeness of lung cancer data from The Health Improvement Network (THIN) national primary care database by comparing incidence and survival between 2000 and 2009 with the UK National Cancer Registry and the National Lung Cancer Audit Database. Secondly, we explored the potential of a geo-demographic social marketing tool to facilitate disease ascertainment by using Experian's Mosaic Public Sector classification, to identify detailed profiles of the sectors of society where lung cancer incidence was highest. Results: Overall incidence of lung cancer (41.4/100, 000 person-years, 95% confidence interval 40.6-42.1) and median survival (232 days) were similar to other national data; The incidence rate in THIN from 2003-2006 was found to be just over 93% of the national cancer registry rate. Incidence increased considerably with area-level deprivation measured by the Townsend Index and was highest in the North-West of England (65.1/100, 000 person-years). Wider variations in incidence were however identified using Mosaic classifications with the highest incidence in Mosaic Public Sector types 'Cared-for pensioners, ' 'Old people in flats' and 'Dignified dependency' (191.7, 174.2 and 117.1 per 100, 000 person-years respectively). Conclusions: Routine electronic data in THIN are a valid source of lung cancer information. Mosaic identified greater incidence differentials than standard area-level measures and as such could be used as a tool for public health programmes to ascertain future cases more effectively.
AB - Background: There is pressing need to diagnose lung cancer earlier in the United Kingdom (UK) and it is likely that research using computerised general practice records will help this process. Linkage of these records to area-level geo-demographic classifications may also facilitate case ascertainment for public health programmes, however, there have as yet been no extensive studies of data validity for such purposes. Methods. To first address the need for validation, we assessed the completeness and representativeness of lung cancer data from The Health Improvement Network (THIN) national primary care database by comparing incidence and survival between 2000 and 2009 with the UK National Cancer Registry and the National Lung Cancer Audit Database. Secondly, we explored the potential of a geo-demographic social marketing tool to facilitate disease ascertainment by using Experian's Mosaic Public Sector classification, to identify detailed profiles of the sectors of society where lung cancer incidence was highest. Results: Overall incidence of lung cancer (41.4/100, 000 person-years, 95% confidence interval 40.6-42.1) and median survival (232 days) were similar to other national data; The incidence rate in THIN from 2003-2006 was found to be just over 93% of the national cancer registry rate. Incidence increased considerably with area-level deprivation measured by the Townsend Index and was highest in the North-West of England (65.1/100, 000 person-years). Wider variations in incidence were however identified using Mosaic classifications with the highest incidence in Mosaic Public Sector types 'Cared-for pensioners, ' 'Old people in flats' and 'Dignified dependency' (191.7, 174.2 and 117.1 per 100, 000 person-years respectively). Conclusions: Routine electronic data in THIN are a valid source of lung cancer information. Mosaic identified greater incidence differentials than standard area-level measures and as such could be used as a tool for public health programmes to ascertain future cases more effectively.
UR - http://www.scopus.com/inward/record.url?scp=81055136563&partnerID=8YFLogxK
U2 - 10.1186/1471-2458-11-857
DO - 10.1186/1471-2458-11-857
M3 - Article
C2 - 22074413
AN - SCOPUS:81055136563
SN - 1471-2458
VL - 11
JO - BMC Public Health
JF - BMC Public Health
M1 - 857
ER -
