Cancer survival in New South Wales, Australia

Socioeconomic disparities remain despite overall improvements

Julia F. Stanbury, Peter D. Baade, Yan Yu, Xue Qin Yu

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Disparities in cancer survival by socioeconomic status have been reported previously in Australia. We investigated whether those disparities have changed over time.

Methods: We used population-based cancer registry data for 377,493 patients diagnosed with one of 10 major cancers in New South Wales (NSW), Australia. Patients were assigned to an area-based measure of socioeconomic status. Five-year relative survival was estimated for each socioeconomic quintile in each 'at risk' period (1996-2000 and 2004-2008) for the 10 individual cancers. Poisson-regression modelling was used to adjust for several prognostic factors. The relative excess risk of death by socioeconomic quintile derived from this modelling was compared over time.

Results: Although survival increased over time for most individual cancers, Poisson-regression models indicated that socioeconomic disparities continued to exist in the recent period. Significant socioeconomic disparities were observed for stomach, colorectal, liver, lung, breast and prostate cancer in 1996-2000 and remained so for 2004-2008, while significant disparities emerged for cervical and uterus cancer in 2004-2008 (although the interaction between period and socioeconomic status was not significant). About 13.4 % of deaths attributable to a diagnosis of cancer could have been postponed if this socioeconomic disparity was eliminated.

Conclusion: While recent health and social policies in NSW have accompanied an increase in cancer survival overall, they have not been associated with a reduction in socioeconomic inequalities.

Original languageEnglish
Article number48
Pages (from-to)1-9
Number of pages9
JournalBMC Cancer
Volume16
DOIs
Publication statusPublished - 1 Feb 2016
Externally publishedYes

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South Australia
New South Wales
Survival
Neoplasms
Uterine Neoplasms
Public Policy
Health Policy
Social Class
Uterine Cervical Neoplasms
Registries
Stomach
Breast Neoplasms
Lung
Liver
Population

Cite this

Stanbury, Julia F. ; Baade, Peter D. ; Yu, Yan ; Yu, Xue Qin. / Cancer survival in New South Wales, Australia : Socioeconomic disparities remain despite overall improvements. In: BMC Cancer. 2016 ; Vol. 16. pp. 1-9.
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title = "Cancer survival in New South Wales, Australia: Socioeconomic disparities remain despite overall improvements",
abstract = "Background: Disparities in cancer survival by socioeconomic status have been reported previously in Australia. We investigated whether those disparities have changed over time. Methods: We used population-based cancer registry data for 377,493 patients diagnosed with one of 10 major cancers in New South Wales (NSW), Australia. Patients were assigned to an area-based measure of socioeconomic status. Five-year relative survival was estimated for each socioeconomic quintile in each 'at risk' period (1996-2000 and 2004-2008) for the 10 individual cancers. Poisson-regression modelling was used to adjust for several prognostic factors. The relative excess risk of death by socioeconomic quintile derived from this modelling was compared over time. Results: Although survival increased over time for most individual cancers, Poisson-regression models indicated that socioeconomic disparities continued to exist in the recent period. Significant socioeconomic disparities were observed for stomach, colorectal, liver, lung, breast and prostate cancer in 1996-2000 and remained so for 2004-2008, while significant disparities emerged for cervical and uterus cancer in 2004-2008 (although the interaction between period and socioeconomic status was not significant). About 13.4 {\%} of deaths attributable to a diagnosis of cancer could have been postponed if this socioeconomic disparity was eliminated. Conclusion: While recent health and social policies in NSW have accompanied an increase in cancer survival overall, they have not been associated with a reduction in socioeconomic inequalities.",
keywords = "Cancer, Disparity, Socioeconomic variation, Survival analysis",
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Cancer survival in New South Wales, Australia : Socioeconomic disparities remain despite overall improvements. / Stanbury, Julia F.; Baade, Peter D.; Yu, Yan; Yu, Xue Qin.

In: BMC Cancer, Vol. 16, 48, 01.02.2016, p. 1-9.

Research output: Contribution to journalArticleResearchpeer-review

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T2 - Socioeconomic disparities remain despite overall improvements

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N2 - Background: Disparities in cancer survival by socioeconomic status have been reported previously in Australia. We investigated whether those disparities have changed over time. Methods: We used population-based cancer registry data for 377,493 patients diagnosed with one of 10 major cancers in New South Wales (NSW), Australia. Patients were assigned to an area-based measure of socioeconomic status. Five-year relative survival was estimated for each socioeconomic quintile in each 'at risk' period (1996-2000 and 2004-2008) for the 10 individual cancers. Poisson-regression modelling was used to adjust for several prognostic factors. The relative excess risk of death by socioeconomic quintile derived from this modelling was compared over time. Results: Although survival increased over time for most individual cancers, Poisson-regression models indicated that socioeconomic disparities continued to exist in the recent period. Significant socioeconomic disparities were observed for stomach, colorectal, liver, lung, breast and prostate cancer in 1996-2000 and remained so for 2004-2008, while significant disparities emerged for cervical and uterus cancer in 2004-2008 (although the interaction between period and socioeconomic status was not significant). About 13.4 % of deaths attributable to a diagnosis of cancer could have been postponed if this socioeconomic disparity was eliminated. Conclusion: While recent health and social policies in NSW have accompanied an increase in cancer survival overall, they have not been associated with a reduction in socioeconomic inequalities.

AB - Background: Disparities in cancer survival by socioeconomic status have been reported previously in Australia. We investigated whether those disparities have changed over time. Methods: We used population-based cancer registry data for 377,493 patients diagnosed with one of 10 major cancers in New South Wales (NSW), Australia. Patients were assigned to an area-based measure of socioeconomic status. Five-year relative survival was estimated for each socioeconomic quintile in each 'at risk' period (1996-2000 and 2004-2008) for the 10 individual cancers. Poisson-regression modelling was used to adjust for several prognostic factors. The relative excess risk of death by socioeconomic quintile derived from this modelling was compared over time. Results: Although survival increased over time for most individual cancers, Poisson-regression models indicated that socioeconomic disparities continued to exist in the recent period. Significant socioeconomic disparities were observed for stomach, colorectal, liver, lung, breast and prostate cancer in 1996-2000 and remained so for 2004-2008, while significant disparities emerged for cervical and uterus cancer in 2004-2008 (although the interaction between period and socioeconomic status was not significant). About 13.4 % of deaths attributable to a diagnosis of cancer could have been postponed if this socioeconomic disparity was eliminated. Conclusion: While recent health and social policies in NSW have accompanied an increase in cancer survival overall, they have not been associated with a reduction in socioeconomic inequalities.

KW - Cancer

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