Understanding the impact of socioeconomic differences in colorectal cancer survival: potential gain in life-years

Br J Cancer. 2019 May;120(11):1052-1058. doi: 10.1038/s41416-019-0455-0. Epub 2019 May 1.

Abstract

Background: Colorectal cancer prognosis varies substantially with socioeconomic status. We investigated differences in life expectancy between socioeconomic groups and estimated the potential gain in life-years if cancer-related survival differences could be eliminated.

Methods: This population-based study included 470,000 individuals diagnosed with colon and rectal cancers between 1998 and 2013 in England. Using flexible parametric survival models, we obtained a range of life expectancy measures by deprivation status. The number of life-years that could be gained if differences in cancer-related survival between the least and most deprived groups were removed was also estimated.

Results: We observed up to 10% points differences in 5-year relative survival between the least and most deprived. If these differences had been eliminated for colon and rectal cancers diagnosed in 2013 then almost 8231 and 7295 life-years would have been gained respectively. This results for instance in more than 1-year gain for each colon cancer male patient in the most deprived group on average. Cancer-related differences are more profound earlier on, as conditioning on 1-year survival the main reason for socioeconomic differences were factors other than cancer.

Conclusion: This study highlights the importance of policies to eliminate socioeconomic differences in cancer survival as in this way many life-years could be gained.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Colorectal Neoplasms / mortality*
  • Female
  • Humans
  • Life Expectancy*
  • Male
  • Social Class*