BACKGROUND: Survival from @entity5 is worse in England than in some European countries. To improve survival, strategies in England have focused on early presentation (reducing delay to improve stage at diagnosis), improving quality of care and ensuring equity throughout the @entity1 pathway. We assessed whether primary care characteristics were associated with later stage @entity5 at diagnosis (stages 3/4 versus 1/2) for female breast, lung, @entity14 . METHODS: Data obtained from the National @entity5 Registration Service, Quality Outcomes Framework, GP survey and GP workforce census, linked by practice code. Risk differences (RD) were calculated by primary care characteristics using a generalised linear model, accounting for @entity1 clustering within practices. Models were adjusted for age, sex and an area-based deprivation measure. RESULTS: For female @entity0 , being with a practice with a higher two week wait (TWW) referral rate (RD -1.8  % (95 % CI -0.5  % to -3.2  %) p   =   0.003) and a higher TWW detection rate (RD -1.7  % (95 % CI -0.3  % to -3.0  %) p   =   0.003) was associated with a lower proportion diagnosed later. Being at a practice where @entity1 thought it less easy to book at appointment was associated with a higher percentage diagnosed later (RD 1.8  % (95 % CI 0.2  % to 3.4  %) p   =   0.03). For @entity2 , being at practices with higher TWW referral rates was associated with lower proportion advanced (RD-3.6  % (95 % CI -1.8  %, -5.5  %) p   <   0.001) whereas being at practices with more @entity1 per GP was associated with higher proportion advanced (RD1.8  % (95 % CI 0.2, 3.4) p   =   0.01). A higher rate of gastrointestinal investigations was associated with a lower proportion of later stage @entity14 (RD -2.0  % (95 % CI -0.6  % to -3.6  %) p   =   0.01). No organisational characteristics were associated with @entity263 stage. CONCLUSION: Easier access to primary care, faster referral and more investigation for gastrointestinal symptoms could reduce the proportion of @entity1 diagnosed later for female breast, lung and colorectal, but not @entity263 . Differences between the four main @entity5 suggest different policies may be required for individual @entity5 to improve outcomes.

Primary care characteristics and stage of XXXX at diagnosis using data from the national @entity5 registration service, quality outcomes framework and general practice information.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'people'] @entity263 :: ('MESH:D011471', 'Disease') :: ['prostate cancer'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast cancer'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancers', 'cancer', 'Cancer'] @entity2 :: ('MESH:D008175', 'Disease') :: ['lung cancer'] @entity14 :: ('MESH:D015179', 'Disease') :: ['colorectal cancers', 'colorectal and prostate cancer']
@entity5 :: (MESH:D009369,Disease) :: ['cancer']
