A cohort study into head and neck cancer mortality in Belgium (2001–11): Are individual socioeconomic differences conditional on area deprivation?

Hagedoorn, Paulien; Vandenheede, Hadewijch; Vanthomme, Katrien; Willaert, Didier; Gadeyne, Sylvie

doi:10.1016/j.oraloncology.2016.08.014

Cited by 32 publications

(29 citation statements)

References 37 publications

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“…Many studies have found that a lower SES is associated with a lower survival rate among HNC patients ( Choi et al, 2016 ; Chu et al, 2016 ; Olsen et al, 2015 ; Osazuwa-Peters et al, 2016 ; Wu et al, 2016 ). Other studies have revealed that neighborhood SES, geographical area, area-level socioeconomic position (SEP), and urban dwelling, all influence HNC patient survival ( Chu et al, 2011 ; Hagedoorn et al, 2016 ; Kuo et al, 2016a ; Wong et al, 2017 ). In general, lower neighborhood SES and rural residence are associated with lower survival rate among HNC patients.…”

Section: Introductionmentioning

confidence: 99%

Effects of income and residential area on survival of patients with head and neck cancers following radiotherapy: working age individuals in Taiwan

Lai

Tang

Chu

et al. 2018

PeerJ

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ObjectivesThe five-year survival rate of head and neck cancer (HNC) after radiotherapy (RT) varies widely from 35% to 89%. Many studies have addressed the effect of socioeconomic status and urban dwelling on the survival of HNC, but a limited number of studies have focused on the survival rate of HNC patients after RT.Materials and methodsDuring the period of 2000–2013, 40,985 working age individuals (20 < age < 65 years) with HNC patients treated with RT were included in this study from a registry of patients with catastrophic illnesses maintained by the Taiwan National Health Insurance Research Database (NHIRD).ResultsThe cumulative survival rate of HNC following RT in Taiwan was 53.2% (mean follow-up period, 3.75 ± 3.31 years). The combined effects of income and geographic effect on cumulative survival rates were as follows: high income group > medium income group > low income group and northern > central > southern > eastern Taiwan. Patients with moderate income levels had a 36.9% higher risk of mortality as compared with patients with high income levels (hazard ratio (HR) = 1.369; p < 0.001). Patients with low income levels had a 51.4% greater risk of mortality than patients with high income levels (HR = 1.514, p < 0.001).ConclusionIn Taiwan, income and residential area significantly affected the survival rate of HNC patients receiving RT. The highest income level group had the best survival rate, regardless of the geographic area. The difference in survival between the low and high income groups was still pronounced in more deprived areas.

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Section: Introductionmentioning

confidence: 99%

Effects of income and residential area on survival of patients with head and neck cancers following radiotherapy: working age individuals in Taiwan

Lai

Tang

Chu

et al. 2018

PeerJ

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“…Inequalities were especially large for preventable cancers related to behavioral change and medical interventions . In addition, previous research has shown an association between lung and head and neck cancer mortality and deprivation at sub‐district and municipal level, respectively . However, the independent role of neighborhood deprivation on a range of cancers has not been studied so far.…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic position, population density and site‐specific cancer mortality: A multilevel analysis of Belgian adults, 2001–2011

Hagedoorn

Vandenheede

Vanthomme

et al. 2017

Intl Journal of Cancer

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Our study explores the association between individual and neighborhood socioeconomic position (SEP) and all-cancer and site-specific cancer mortality. Data on all Belgian residents are retrieved from a population-based dataset constructed from the 2001 census linked to register data on emigration and mortality for [2001][2002][2003][2004][2005][2006][2007][2008][2009][2010][2011]. The study population contains all men and women aged 40 years or older during follow-up. Individual SEP is measured using education, employment status and housing conditions. Neighborhood SEP is measured by a deprivation index (in quintiles). Directly age-standardized mortality rates and multilevel Poisson models are used to estimate the association between individual SEP and neighborhood deprivation and mortality from all-cancer and cancer of the lung, colon and rectum, pancreas, prostate and female breast. The potential confounding role of population density is assessed using multilevel models as well. Our findings show an increase in mortality from all-cancer and site-specific cancer by decreasing level of individual SEP for both men and women. In addition, individuals living in highly deprived neighborhoods experience significantly higher mortality from all-cancer, lung cancer, pancreatic cancer and female colorectal cancer after controlling for individual SEP. Male colorectal and prostate cancer and female breast cancer are not associated with neighborhood deprivation. Population density acts as a confounder for female lung cancer only. Our study indicates that deprivation at both the individual and neighborhood level is associated with all-cancer mortality and mortality from several cancer sites. More research into the role of life-style related and clinical factors is necessary to gain more insight into causal pathway.

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“…Studies have shown that area-level deprivation not only serves as an individual-level proxy when data are unavailable but also has its own impact (Hagedoorn et al 2016;Spadea et al 2010). Moreover, policy decisions regarding, for example, resources allocation and healthcare organisations, are made on a larger scale than individual or census section Measuring Change Over Time in Socio-economic Deprivation… 123 levels.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it is important to interpret results while considering the risk of ecological fallacy ['not all deprived individuals live in deprived wards, just as not everybody in a ward ranked as deprived are deprived themselves' (Townsend et al 1988)]. Although a relevant issue, it is difficult to obtain individual deprivation measures and both individual-and area-level deprivation are important determinants of health status (Hagedoorn et al 2016;Spadea et al 2010). Thus, small area indexes should identify 'environmental' components underlying social differences as a proxy for unknown individual characteristics.…”

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confidence: 99%

Measuring Change Over Time in Socio-economic Deprivation and Health in an Urban Context: The Case Study of Genoa

2017

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A cohort study into head and neck cancer mortality in Belgium (2001–11): Are individual socioeconomic differences conditional on area deprivation?

Cited by 32 publications

References 37 publications

Effects of income and residential area on survival of patients with head and neck cancers following radiotherapy: working age individuals in Taiwan

Effects of income and residential area on survival of patients with head and neck cancers following radiotherapy: working age individuals in Taiwan

Socioeconomic position, population density and site‐specific cancer mortality: A multilevel analysis of Belgian adults, 2001–2011

Measuring Change Over Time in Socio-economic Deprivation and Health in an Urban Context: The Case Study of Genoa

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