Deprivation gap in colorectal cancer survival attributable to stage at diagnosis: A population-based study in Spain

Núñez, Olivier; Rodriguez‐Barranco, Miguel; Fernández-Navarro, Pablo; Redondo-Sánchez, Daniel; Fernández, Miguel Ángel Luque; Santamaría, Marina Pollán; Sánchez, María‐José

doi:10.1016/j.canep.2020.101794

Cited by 6 publications

(8 citation statements)

References 30 publications

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“…For colon cancer in females, our results suggest that social inequalities accumulate almost exclusively in the first months after diagnosis. This confirms data obtained with different models in England, Ireland and Spain, some of which explained social inequalities in survival mainly by the stage of extension at the time of diagnosis of the disease and treatment [24,27,30,32,33]. Similar results have been reported for rectal cancer with a high frequency of patients presenting in an emergency setting [27] and for both colon and rectal localizations combined [30].…”

Section: Discussionsupporting

confidence: 87%

Socioeconomic Environment and Survival in Patients with Digestive Cancers: A French Population-Based Study

Tron

Fauvernier

Bouvier

et al. 2021

Cancers

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Social inequalities are an important prognostic factor in cancer survival, but little is known regarding digestive cancers specifically. We aimed to provide in-depth analysis of the contextual social disparities in net survival of patients with digestive cancer in France, using population-based data and relevant modeling. Digestive cancers (n = 54,507) diagnosed between 2006–2009, collected through the French network of cancer registries, were included (end of follow-up 06/30/2013). Social environment was assessed by the European Deprivation Index. Multidimensional penalized splines were used to model excess mortality hazard. We found that net survival was significantly worse for individuals living in a more deprived environment as compared to those living in a less deprived one for esophageal, liver, pancreatic, colon and rectal cancers, and for stomach and bile duct cancers among females. Excess mortality hazard was up to 57% higher among females living in the most deprived areas (vs. least deprived) at 1 year of follow-up for bile duct cancer, and up to 21% higher among males living in the most deprived areas (vs. least deprived) regarding colon cancer. To conclude, we provide a better understanding of how the (contextual) social gradient in survival is constructed, offering new perspectives for tackling social inequalities in digestive cancer survival.

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Section: Discussionsupporting

confidence: 87%

Socioeconomic Environment and Survival in Patients with Digestive Cancers: A French Population-Based Study

Tron

Fauvernier

Bouvier

et al. 2021

Cancers

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“…To add evidence to this hypothesis, however, research that includes a period before the implementation phase (2005‐2009) of the mammography screening programme is needed. Finally, our finding of an association of area socioeconomic deprivation with tumour size of colorectal cancer and malignant melanoma is in line with findings from numerous international studies 12,13,15‐18 . In particular, a recent nationwide study from the United Kingdom that used TNM staging showed an association of high income deprivation with an advanced stage of colon cancer, rectal cancer, and malignant melanoma.…”

Section: Discussionsupporting

confidence: 91%

“…Finally, our finding of an association of area socioeconomic deprivation with tumour size of colorectal cancer and malignant melanoma is in line with findings from numerous international studies. 12,13,[15][16][17][18] In particular, a recent nationwide study from the United Kingdom that used TNM staging showed an association of high income deprivation with an advanced stage of colon cancer, rectal cancer, and malignant melanoma. Moreover, their results agree with our study in terms of a null finding for uterine cancer.…”

Section: 00mentioning

confidence: 99%

Regional inequalities of tumour size at diagnosis in Germany: An ecological study in eight federal states

Jaehn

Bergholz

Holmberg

2022

Intl Journal of Cancer

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There is growing recognition of the importance of the residential environment for early detection of cancer. However, few studies have investigated area socioeconomic deprivation, social capital, and rurality in combination. Therefore, we aimed to estimate mutually adjusted associations of these characteristics with tumour size at diagnosis in Germany. We included incident cases of female breast cancer, colorectal cancer, malignant melanoma, uterine cancer, and male bladder cancer, collected by the cancer registries of eight German federal states between 2010 and 2014. Using information on T status at diagnosis, we defined an advanced tumour size for each cancer type. Sex‐specific mutually adjusted associations of area socioeconomic deprivation, social capital, and rurality with an advanced tumour size and variance partition coefficients were estimated in multilevel logistic regression. Missing data of the outcome were addressed by multiple imputation. Overall, 386 223 cases were included in this analysis. High area socioeconomic deprivation was associated with an advanced tumour size at diagnosis of colorectal cancer and malignant melanoma. For malignant melanoma, low social capital was associated with an advanced tumour size among females and males, while a rural settlement structure was associated with an advanced tumour size among males only. Since meaningful general contextual effects were found for malignant melanoma, our results underscore that the residential environment is an important predictor of melanoma tumour size. Secondary prevention programmes for this cancer type should target areas with high area socioeconomic deprivation, low social capital, and a rural settlement structure in order to reach those most vulnerable.

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“…As already mentioned, the incidence of cancer is closely linked to social and economic conditions in Spain and other European countries [2,[9][10][11]. Although the pandemic may have aggravated these inequalities, it cannot be ruled out that the possible delay in diagnosis may have affected the entire population to a greater or lesser extent -including those with a…”

Section: Is There Evidence That Tumors Diagnosed In the Pandemic Peri...mentioning

confidence: 99%

Impact of the COVID-19 pandemic on the diagnosis and treatment of onco-hematologic patients: a discussion paper

Bouza

Martı́n²,

Alés³

et al. 2022

Rev Esp Quimioter

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We do not know the precise figure for solid organ tumors diagnosed each year in Spain and it is therefore difficult to calculate whether there has been a decrease in cancer diagnoses as a consequence of the pandemic. Some indirect data suggest that the pandemic has worsened the stage at which some non-hematological neoplasms are diagnosed. Despite the lack of robust evidence, oncology patients seem more likely to have a poor outcome when they contract COVID-19. The antibody response to infection in cancer patients will be fundamentally conditioned by the type of neoplasia present, the treatment received and the time of its administration. In patients with hematological malignancies, the incidence of infection is probably similar or lower than in the general population, due to the better protective measures adopted by the patients and their environment. The severity and mortality of COVID-19 in patients with hematologic malignancies is clearly higher than the general population. Since the immune response to vaccination in hematologic patients is generally worse than in comparable populations, alternative methods of prevention must be established in these patients, as well as actions for earlier diagnosis and treatment. Campaigns for the early diagnosis of malignant neoplasms must be urgently resumed, post-COVID manifestations should be monitored, collaboration with patient associations is indisputable and it is urgent to draw the right conclusions to improve our preparedness to fight against possible future catastrophes.

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Deprivation gap in colorectal cancer survival attributable to stage at diagnosis: A population-based study in Spain

Cited by 6 publications

References 30 publications

Socioeconomic Environment and Survival in Patients with Digestive Cancers: A French Population-Based Study

Socioeconomic Environment and Survival in Patients with Digestive Cancers: A French Population-Based Study

Regional inequalities of tumour size at diagnosis in Germany: An ecological study in eight federal states

Impact of the COVID-19 pandemic on the diagnosis and treatment of onco-hematologic patients: a discussion paper

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