Levels of acute health service use among cancer survivors in the United Kingdom

Abstract

Background: In the United Kingdom, there are approximately two million cancer survivors (3.2% of the entire population), composed of groups of people in different phases of survivorship and with different health service needs. The aim of this study was to quantify the level of acute health service utilisation by cancer survivors in the UK, according to tumour type, age, sex, time since diagnosis, and time until death.

Methods: Linked national cancer registry and hospital activity data were analysed. The data covered all cancer-related admissions to public hospitals operated by the National Health Service in England occurring in 2006 among people diagnosed with cancer in the period 1990-2006. The intensity of cancer-related health service utilisation was categorised as 'none', 'low' (up to 10% of an individual's time), or 'high' (>10% of an individual's time), among groups defined by time since diagnosis and time until death. Results were extrapolated from the population of England in 2006 (51 million) to that of the UK in 2008 (61 million).

Findings: Sixty one thousand of the two million cancer survivors (3%) were in the 'high' utilisation category; 240,000 (12%) were in the 'low' category; 1.70 million (85%) had no cancer-related hospital admissions. 147,000 cancer survivors (7%) were in the last year of their life, and it was this group that had the highest levels of hospital utilisation. 1.57 million cancer survivors (78%) were more than 1 year from both diagnosis and death, and had no cancer related hospital admissions.

Interpretation: A considerable proportion of cancer survivors in the UK have a high level of hospital utilisation soon after diagnosis or before death, but the large majority of them are neither recently diagnosed nor near the end of their life, and do not utilise acute health services for cancer-related care.