Effect of Area-Level Deprivation on Cancer Survival Time: A Register-Based Follow-up Study of 145 585 Korean Subjects

Asia Pac J Public Health. 2018 Jan;30(1):19-28. doi: 10.1177/1010539517746043. Epub 2017 Dec 7.

Abstract

Our goal is to evaluate the strengths of the associations between area-level deprivation and survival time for a variety of cancers. A total of 145 585 subjects were diagnosed with various cancers in Busan, Korea, and an area-level deprivation index constructed from several important socioeconomic variables. A multilevel Cox model was used in the analysis to investigate the effects of multiple risk factors. After adjusting for gender and age, an increased area-level deprivation index was found to be significantly associated with a higher hazard rate for major cancers. Estimated hazard ratios (95% confidence interval) were 1.08 (1.06, 1.11), 1.15 (1.13, 1.18), and 1.22 (1.18, 1.25) for the second, third, and fourth quartiles of deprivation index groups, respectively, when compared with the least deprived group. When compared with the least deprived group, the more deprived group showed significant decrease in survival time for major cancers. This finding highlights the importance of preventive and care services incorporating socioeconomic characteristics of areas.

Keywords: area-level deprivation; cancer; cancer mortality; hazard ratio; survival time.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Health Status Disparities*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Neoplasms / mortality*
  • Poverty Areas*
  • Proportional Hazards Models
  • Registries
  • Republic of Korea / epidemiology
  • Risk Factors
  • Socioeconomic Factors
  • Survival Analysis
  • Young Adult