RT Journal Article T1 Investigating the inequalities in route to diagnosis amongst patients with diffuse large B-cell or follicular lymphoma in England. A1 Smith, Matthew J A1 Luque-Fernandez, Miguel-Angel A1 Belot, Aurelien A1 Quartagno, Matteo A1 Bonaventure, Audrey A1 Majano, Sara Benitez A1 Rachet, Bernard A1 Njagi, Edmund Njeru AB Diagnostic delay is associated with lower chances of cancer survival. Underlying comorbidities are known to affect the timely diagnosis of cancer. Diffuse large B-cell (DLBCL) and follicular lymphomas (FL) are primarily diagnosed amongst older patients, who are more likely to have comorbidities. Characteristics of clinical commissioning groups (CCG) are also known to impact diagnostic delay. We assess the association between comorbidities and diagnostic delay amongst patients with DLBCL or FL in England during 2005-2013. Multivariable generalised linear mixed-effect models were used to assess the main association. Empirical Bayes estimates of the random effects were used to explore between-cluster variation. The latent normal joint modelling multiple imputation approach was used to account for partially observed variables. We included 30,078 and 15,551 patients diagnosed with DLBCL or FL, respectively. Amongst patients from the same CCG, having multimorbidity was strongly associated with the emergency route to diagnosis (DLBCL: odds ratio 1.56, CI 1.40-1.73; FL: odds ratio 1.80, CI 1.45-2.23). Amongst DLBCL patients, the diagnostic delay was possibly correlated with CCGs that had higher population densities. Underlying comorbidity is associated with diagnostic delay amongst patients with DLBCL or FL. Results suggest a possible correlation between CCGs with higher population densities and diagnostic delay of aggressive lymphomas. PB Nature Publishing Group YR 2021 FD 2021-08-03 LK http://hdl.handle.net/10668/18373 UL http://hdl.handle.net/10668/18373 LA en NO Smith MJ, Fernandez MAL, Belot A, Quartagno M, Bonaventure A, Majano SB, et al. Investigating the inequalities in route to diagnosis amongst patients with diffuse large B-cell or follicular lymphoma in England. Br J Cancer. 2021 Oct;125(9):1299-1307. NO This research was funded by Cancer Research UK grant number C7923/A18525. The authors declare no support from any organisations for the submitted work. The design of the study, the analyses and the writing of the manuscript were solely the responsibility of the authors. The findings and conclusions in this manuscript are thoseof the authors and do not necessarily represent the views of Cancer Research UK DS RISalud RD Apr 17, 2025