Socioeconomic status predicts survival of Canadian cancer patients: Queen's study
Cancer patients from poorer communities have a greater chance of dying prematurely than individuals from more affluent backgrounds, according to a recent Queen’s University study.
“Differences in survival across social groups were first described in Ontario in the 1990s. It remains unclear why these disparities exist in the 21st century despite universal health care. As clinicians, researchers and policy-makers we need to work towards understanding and correcting these disparities,” says assistant professor Christopher Booth, lead researcher on the study.
The research team analyzed all cases of breast, colon, rectal, non-small-cell lung, cervical, and laryngeal cancer diagnosed in Ontario from 2003 to 2007, as identified through the Ontario Cancer Registry. Patients were divided into groups based on median household income reported in the 2001 Canadian census.
Despite universal healthcare, significant differences in survival across socioeconomic groups persist in Ontario: overall and cancer-specific survival of patients from poorer communities was lower than that of patients residing in more affluent neighborhoods. The researchers observed only very modest differences in cancer stage at the time of diagnosis across socioeconomic groups, contrasting with much of the existing literature from the United States.
“It is plausible that the lack of a strong association between stage of disease and socioeconomic status in our study relates to the presence of universal health coverage in Ontario, which may facilitate access to primary care physicians and/or cancer screening,” says Dr. Booth.
Instead, factors such as differences in cancer biology, the presence of other illnesses, access to treatment, and quality of care might play a role. The authors noted that additional work is needed to better understand these factors and to develop strategies to reduce disparities in the survival of patients with cancer.
Dr. Booth is also a researcher at the Queen’s Cancer Research Institute and an oncologist at the Cancer Centre of Southeastern Ontario at Kingston General Hospital.
The results of the study are online in CANCER, a peer-reviewed journal of the American Cancer Society.