Risk Factors

Cancer survival gap widens between the haves and have-nots


There is widening gap in cancer survival between people who live in the most socioeconomically disadvantaged areas and those who live in the least disadvantaged areas, according to data from the NSW Cancer Registry.

The cohort study, including more than 651,000 cases of localised cancer diagnosed between January 1980 and December 2008, also found residential remoteness contributed to an increased risk of cancer death but was not increasing over time.

The study found the disparities, consistent with other national and international evidence, existed despite cancer site, stage at diagnosis and death from other events.

“Although effect sizes were generally small, they point to possible areas of disadvantage probably including pockets of more severe disadvantage than applying to these areas overall,” the study said.

An analysis by cancer type showed the association was strongest for liver, melanoma, prostate, lung, colorectal and breast cancer.

The researchers suggested the survival gradient for some cancers such as liver and lung may be explained by differences in risk behaviour and co-morbidities.

“For colon/rectum, cervix and prostate cancers, these findings may partly be explained by access to and uptake of screening services and other early-detection initiatives.”

The study also found that except for melanoma and breast cancer, people born in non-English speaking countries had a lower risk of cancer death than people born in Australia.

They postulated it might be explained by the ‘healthy migrant’ effect.

People born in other English-speaking countries had similar risk of cancer deaths with the exception of a lower risk of cervical cancer.

While acknowledging efforts such as telehealth to mitigate geographical disadvantage, the researchers called for a renewed focus and targeted actions to address socioeconomic disadvantage.

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