Title : Using the national cancer registry to explore health inequalities in renal cell carcinoma in England

Health inequalities are a major challenge, particularly within cancer research, and remain a key priority for the NHS. Those who reside in the most deprived populations in the United Kingdom (UK) have a higher prevalence of risk factors, lower symptom awareness and experience more barriers to seek help. This results in diagnoses at later stages where prognosis is worse, and treatment options are limited. Understanding inequalities in cancer diagnosis, treatments and outcomes requires data that captures disparities by demographic, clinical and geographic characteristics. The linkage of patient-level datasets, including National Cancer Registry (NCRAS), Hospital Episodes Statistics (HES) and Systemic Anti-cancer Therapy Registry (SACT) provides the opportunity to investigate health inequalities through longitudinal epidemiological studies at a population-level using real-world data. The aim of this project is to use linked patient-level data from national registries to explore inequalities in the receipt of immuno-, biological and precision therapies (IBPs) in renal cell carcinoma (RCC) patients in England between 2013-2021. Patients diagnosed at 15 years or older with a primary diagnosis of RCC (ICD10 C64) between 2013-2021 were included in this analysis. Linkage of HES and SACT datasets to the Cancer Registry provided a comprehensive patient record of treatment receipt along with patient characteristics. Midyear population estimates from the Office of National Statistics (ONS) along with the European Standard Population were used to calculate age-standardised rates (ASR) of incidence. Findings revealed that incidence of RCC vary greatly by sex, age and deprivation. Differences in survival by deprivation potential indicate socioeconomic inequalities in outcomes for this particular patient cohort. A difference of 10% was found for 10-year net survival estimates between patients in London compared with patients in the East of England. Although findings are preliminary and exploratory they demonstrate the successful linkage of national datasets for the use in epidemiological research. This work provides the foundations for future analysis investigating where in the pathway inequalities emerge, looking further into access and time to receipt of treatment.

Emily Shaw is a final year PhD student at Newcastle University, UK, funded by NIHR through the Patient Safety Research Collaboration (PSRC). Her research focuses on disadvantaged communities and health inequalities, with particular focus on renal cell carcinoma (RCC). Emily is a quantitative researcher using national cancer registries and datasets to explore treatment utilization and patient outcomes.