Origins of socio-economic inequalities in cancer survival: a review

Woods, Laura; Rachet, Bernard; Coleman, Michel P

doi:10.1093/annonc/mdj007

Cited by 586 publications

(614 citation statements)

References 103 publications

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“…In addition, unmarried NSCLC patients are easier exposed to suicide attempts. Married patients have a greater socioeconomic status than unmarried 30, 31. Many cancer research studies have reported a poor prognosis in unmarried patients 32, 33, 34…”

Section: Discussionmentioning

confidence: 99%

Trends in incidence and associated risk factors of suicide mortality in patients with non‐small cell lung cancer

et al. 2018

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Lung cancer patients have an increased risk for committing suicide. But no comprehensive study about the suicide issues among non‐small‐cell lung cancer (NSCLC) patients has been published. We aimed to estimate the trend of suicide rate and identify the high‐risk group of NSCLC patients. Patients diagnosed with primary NSCLC were identified from Surveillance, Epidemiology, and End Results (SEER) database (1973‐2013). Suicide mortality rate (SMR) were calculated. Multivariable logistic regression was employed to find out independent risk factors for suicide. Among 495 889 NSCLC patients, 694 (0.14%) of them died from suicide. The suicide mortality rates have significantly decreased (before 1993: 0.21%, 1994‐2003: 0.16%, after 2004: 0.09%, P < .001). Male (OR 6.22, 95% CI: 4.96‐7.98, P < .001), white (OR 3.89, 95% CI: 2.66‐5.97, P < .001), being unmarried (OR 1.43, 95% CI: 1.22‐1.67, P < .001), the elderly (60‐74 vs <60: OR 1.24, 95% CI: 1.03‐1.50, P = .024, >75 vs <60: OR 1.31, 95% CI: 1.05‐1.63, P = .018) were independently associated with higher risk of suicide mortality. Surgery (OR: 1.44, 95% CI: 1.19‐1.73, P < .001) was also relative with higher risk of suicide. Our study observed significant decrease in suicide mortality among NSCLC patients in US over past decades. Older age, male sex, unmarried status, and surgery were risk factors of committing suicide. Clinicians should be aware of these high‐risk groups.

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Section: Discussionmentioning

confidence: 99%

Trends in incidence and associated risk factors of suicide mortality in patients with non‐small cell lung cancer

et al. 2018

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“…Differences in the uptake of screening, 22 stage at diagnosis, 3 level of comorbidity 23,24 and access to optimal treatment 25 are all potential explanations for the difference in cancer survival between rich and poor patients. Whilst differences in stage at diagnosis and comorbidity have explained only a small proportion of the socioeconomic disparities in survival from colorectal cancer, 26 differential access to healthcare has been shown to strongly influence these inequalities in survival.…”

Section: Discussionmentioning

confidence: 99%

“…2 The percentage of avoidable deaths is the number of avoidable deaths as a proportion of all excess deaths 3 The number of avoidable deaths partly depends on the deficit in relative survival between affluent and deprived groups. If survival for a particular cancer is higher in deprivation categories 2-5 than the most affluent category (1), the number and proportion of avoidable deaths can be negative.…”

Section: Conflict Of Interestsmentioning

confidence: 99%

“…1,2 The origins of these disparities in survival are still not fully understood, but factors such as stage at diagnosis and access to optimal treatment have been implicated. 3 Such observations suggest that deprived patients do not benefit equally from health-care services in the UK, despite a universal health-care system that is free to all at the point of use. Quantifying the public health impact of these inequalities in cancer survival is important to inform health policy.…”

Section: Introductionmentioning

confidence: 99%

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How many deaths would be avoidable if socioeconomic inequalities in cancer survival in England were eliminated? A national population-based study, 1996–2006

Ellis

Coleman

Rachet

2012

European Journal of Cancer

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Ellis, L; Coleman, MP; Rachet, B (2011) How many deaths would be avoidable if socioeconomic inequalities in cancer survival in England were eliminated? A national population-based study, 1996-2006. European journal of cancer (Oxford, England , 48 (2 This study aims to quantify the public health impact of these inequalities by estimating the number of cancer-related deaths that would be avoidable if all patients were to have the same survival as the most affluent patients. MethodsNational Cancer Registry data for all adults diagnosed with one of 21 common cancers in England were used to estimate relative survival. We estimated the number of excess (cancer-related) deaths that would be avoidable within three years after diagnosis if relative survival for patients in all deprivation groups were as high as the most affluent group. ResultsFor patients diagnosed during [2004][2005][2006] 7122 of the 64,940 excess deaths a year (11%) would have been avoidable if three-year survival for all patients had been as high as in the most affluent group. The annual number of avoidable deaths fell from 8435 (13%) a year for patients diagnosed during 1996-2000. Over 60% of the total number of avoidable deaths occurred within six months after diagnosis and approximately 70% occurred in the two most deprived groups. ConclusionThe downward trend in the annual number of avoidable deaths reflects more an improvement in survival in England overall, rather than a narrowing of the deficit in cancer survival between rich and poor. The lack of any substantial change in the percentage of avoidable excess deaths highlights the persistent nature of the deficit in survival between affluent and deprived groups.248 words

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“…In many countries, cancer outcomes are better in women and men with high compared to low socioeconomic status (SES) 1, 2. This association has also been observed in Sweden, a country with a tax‐financed national health care system aiming to provide care on equal terms to all residents 3, 4, 5…”

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confidence: 83%

Socioeconomic status and diagnosis, treatment, and mortality in men with prostate cancer. Nationwide population‐based study

Tomic

Ventimiglia

Robinson

et al. 2018

Intl Journal of Cancer

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Patients with high socioeconomic status (SES) have better cancer outcomes than patients with low SES. This has also been shown in Sweden, a country with tax‐financed health care aiming to provide care on equal terms to all residents. The association between income and educational level and diagnostics and treatment as outlined in national guidelines and prostate cancer (Pca) and all‐cause mortality was assessed in 74,643 men by use of data in the National Prostate Cancer Register of Sweden and a number of other health care registers and demographic databases. In multivariable logistic regression analysis, men with high income had higher probability of Pca detected in a health‐check‐up, top versus bottom income quartile, odds ratio (OR) 1.60 (95% CI 1.45–1.77) and lower probability of waiting more than 3 months for prostatectomy, OR 0.77 (0.69–0.86). Men with the highest incomes also had higher probability of curative treatment for intermediate and high‐risk cancer, OR 1.77 (1.61–1.95) and lower risk of positive margins, (incomplete resection) at prostatectomy, OR 0.80 (0.71–0.90). Similar, but weaker associations were observed for educational level. At 6 years of follow‐up, Pca mortality was modestly lower for men with high income, which was statistically significant for localized high‐risk and metastatic Pca in men with no comorbidities. All‐cause mortality was less than half in top versus bottom quartile of income (12% vs. 30%, p < 0.001) among men above age 65. Our findings underscore the importance of adherence to guidelines to ensure optimal and equal care for all patients diagnosed with cancer.

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Origins of socio-economic inequalities in cancer survival: a review

Cited by 586 publications

References 103 publications

Trends in incidence and associated risk factors of suicide mortality in patients with non‐small cell lung cancer

Trends in incidence and associated risk factors of suicide mortality in patients with non‐small cell lung cancer

How many deaths would be avoidable if socioeconomic inequalities in cancer survival in England were eliminated? A national population-based study, 1996–2006

Socioeconomic status and diagnosis, treatment, and mortality in men with prostate cancer. Nationwide population‐based study

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