ArticleJournal of epidemiology and community health2021
Socioeconomic gaps over time in colorectal cancer survival in England: flexible parametric survival analysis.
Article in Journal of epidemiology and community health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Intersectional inequalities in advanced stage diagnosis of colorectal cancer in England: a cross-sectional study of National Cancer Registry data from 2013 to 2019.Journal of epidemiology and community health · 2026Article
- Colorectal Cancer Screening using Immunochemical Faecal Occult Blood Testing (iFOBT) in Urban-Poor Communities in Cheras, Malaysia: A Cross-Sectional Study.The Malaysian journal of medical sciences : MJMS · 2025Article
- Income disparities in loss in life expectancy after colon and rectal cancers: a Swedish register-based study.Journal of epidemiology and community health · 2024Article
- Inequalities in treatment among patients with colon and rectal cancer: a multistate survival model using data from England national cancer registry 2012-2016.British journal of cancer · 2024Article
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5 authors.
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Abstract
backgroundDespite persistent reports of socioeconomic inequalities in colorectal cancer survival in England, the magnitude of survival differences has not been fully evaluated.
methodsPatients diagnosed with colon cancer (n=68 169) and rectal cancer (n=38 267) in England (diagnosed between January 2010 and March 2013) were analysed as a retrospective cohort study using the National Cancer Registry data linked with other population-based healthcare records. The flexible parametric model incorporating time-varying covariates was used to assess the difference in excess hazard of death and in net survival between the most affluent and the most deprived groups over time.
resultsSurvival analyses showed a clear pattern by deprivation. Hazard ratio of death was consistently higher in the most deprived group than the least deprived for both colon and rectal cancer, ranging from 1.08 to 1.17 depending on the model. On the net survival scale, the socioeconomic gap between the most and the least deprived groups reached approximately -4% at the maximum (-3.7%, 95% CI -1.6 to -5.7% in men, -3.6%, 95% CI -1.6 to -5.7% in women) in stages III for colon and approximately -2% (-2.3%, 95% CI -0.2 to -4.5% in men, -2.3%, 95% CI -0.2 to -4.3% in women) in stage II for rectal cancer at 3 years from diagnosis, after controlling for age, emergency presentation, receipt of resection and comorbidities. The gap was smaller in other stages and sites. For both cancers, patients with emergency presentation persistently had a higher excess hazard of death than those without emergency presentation.
conclusionSurvival disparities were profound particularly among patients in the stages, which benefit from appropriate and timely treatment. For the patients with emergency presentation, excess hazard of death remained high throughout three years from the diagnosis. Public health measures should be taken to reduce access inequalities to improve survival disparities.
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