Over two-thirds of brain cancers, and a third of all cancers, in NHS patients aged over 70 are only diagnosed following emergency hospital admissions.

A study by the National Cancer Intelligence Network found that elderly patients made up two-thirds of the patients whose cancers were diagnosed by that route.

Importantly, it found that patients were far less likely to survive a year if their diagnosis came through A&E rather than an outpatient referral.

According to the study, which looked at 750,000 patients in England, 70% of brain cancers, 55% of pancreatic cancers and 52% of liver cancers in patients aged over 70 were diagnosed via emergency admissions in 2006–8.

Also, 39% of all lung cancers were only diagnosed after an A&E admission.

Study co-author Sara Hiom, Director of Information at Cancer Research UK, said: “We don’t yet know the reasons that lie behind these stark figures, but we urgently need to understand why there is such a great proportion.”

Possible explanations were that elderly patients were “reluctant to bother their doctor,” she said, or that doctors were dismissing symptoms as ‘old age’. In some cases the A&E admissions were emergency GP referrals.

According to Professor Sir Mike Richards, the National Cancer Director, improved awareness of the symptoms of hard-to-detect cancers could reduce the need for emergency diagnoses.

“A public awareness campaign run in Leeds showed that the proportion of emergency presentations can be reduced,” he noted. “Correspondingly more patients were diagnosed through the urgent outpatient route.”

National Cancer Director Mike Richards has outlined plans for a series of public awareness campaigns promoting early diagnosis of cancer.

The DH plans to repeat its national bowel cancer campaign, followed by local campaigns focused on ovarian cancer and ‘constellations’ of cancer symptoms.

Regional pilots are planned for campaigns around breast cancer in elderly women and renal/bladder cancer.

In a letter to NHS trust and PCT chief executives, Richards emphasises the importance of early diagnosis for improving cancer survival rates and notes the Government’s aim of saving 5,000 more lives per year by 2014/15.

The national bowel cancer awareness campaign that ran from January to March 2012 achieved a 50% increase in urgent GP referrals for suspected colorectal cancer in regions not involved in the pilot campaigns.

To build on this effect, the DH plans to repeat this campaign for four weeks from 28 August, using a range of advertising and community engagement strategies. It warns trusts that the campaign may increase pressure on secondary care facilities.

From January to mid-March 2013 the DH will test local campaigns on ovarian cancer and cancer symptom ‘constellations’, and will run regional pilots of campaigns on breast cancer in women over 70 and blood in urine (a potential symptom of renal or bladder cancer).

Hosted by regional Cancer Networks, the campaigns will form part of a national partnership programme to combine primary care and diagnostic services.