Geographical Variation and Factors Associated with Colorectal Cancer Mortality in a Universal Health Care System

Torabi, Mahmoud; Green, Christopher; Nugent, Zoann; Mahmud, Salaheddin M.; Demers, Alain; Griffith, Jane; Singh, Harminder

doi:10.1155/2014/707420

Cited by 23 publications

(29 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…8 Our current study suggests that delayed/late stage diagnosis is likely not a major contributor to such differences in Manitoba. We have also reported lower CRC screening rates in areas with lower mean household income in Winnipeg.…”

Section: Discussionmentioning

confidence: 53%

“…However, we recently reported an increase in CRC mortality among individuals residing in lower income areas in Manitoba, one of the central Canadian provinces. 8 This could be due to biological differences in CRC, environmental differences (e.g., diet), delayed diagnosis of CRC or worsening survival after CRC diagnosis (due to inadequate treatment or response to treatment), or multiple factors. The implications for public health are vastly different for delayed diagnosis, biological differences, and worsening survival.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Geographic variation and factors associated with colorectal cancer incidence in Manitoba

Singh

Nugent

Decker

et al. 2017

Can J Public Health

Self Cite

View full text Add to dashboard Cite

OBJECTIVES: Although individuals living in areas with lower household income have been shown to have higher rates of mortality from colorectal cancer (CRC), findings on the effect of income on CRC incidence in countries with universal health care have been inconsistent. There are limited data from Canada. We investigated the geographic variation and factors associated with CRC incidence in Manitoba, a central Canadian province. METHODS:The Manitoba Cancer Registry and Manitoba Health population registry were used to determine age-sex-standardized CRC incidence rates between 1985 and 2012, which were geocoded to 498 small geographic areas (SGAs). The 2001 Canadian Census was used to determine the sociodemographic characteristics of the SGAs. Bayesian spatial Poisson modelling was used to assess geographic variation and factors associated with CRC incidence.RESULTS: CRC incidence in SGAs ranged from 11 to 1026 per 100 000 population per year. Importantly, in the fully adjusted model there was no significant association between either average household income or proportion of recent immigrants in the SGAs and CRC incidence. Individuals living in urban areas had an overall lower CRC incidence (incidence rate ratio: 0.76; 95% credible interval: 0.58-0.98). CONCLUSIONS:In a province with a universal health care system, our study suggests there are no disparities in CRC incidence by socio-economic level of the areas of residence. Rural areas should be a focus of CRC reduction initiatives in Manitoba. Similar analysis in other jurisdictions should be performed to evaluate the effect of the characteristics of SGAs on CRC incidence in different settings and target some of the efforts to reduce CRC burden.KEY WORDS: Epidemiology; spatial analysis; variation in risk; disparities La traduction du résumé se trouve à la fin de l'article.

show abstract

Section: Discussionmentioning

confidence: 53%

mentioning

confidence: 99%

Geographic variation and factors associated with colorectal cancer incidence in Manitoba

Singh

Nugent

Decker

et al. 2017

Can J Public Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…The income disparities in CRC screening rates are concerning, especially because we recently reported widening disparities in CRC mortality by income group. 30 The results of these 2 studies suggest that people who need higher rates of CRC screening because they have higher CRC-related mortality are less likely to receive CRC screening and therefore should be a target group for CRC screening programs.…”

Section: Discussionmentioning

confidence: 99%

Screening rates for colorectal cancer in Canada: a cross-sectional study

et al. 2015

View full text Add to dashboard Cite

Introduction: Implementation of population-based colorectal cancer (CRC) screening programs should reduce disparities in participation in CRC screening. We estimated CRC screening rates in 2012 in Canada and assessed predictors of screening in provinces with and without well-established population-based screening programs. Methods:We used data from the Canadian Community Health Survey for 2012 to calculate the prevalence of up-to-date CRC screening, defined as fecal occult blood testing (FOBT) within 2 years before the survey or flexible sigmoidoscopy or colonoscopy within 10 years before the survey, or both. Weighted proportions of individuals with up-to-date screening were calculated and logistic regression analysis performed to assess predictors of up-to-date CRC screening, including differences in participation by income level. Results:The prevalence of up-to-date CRC screening among people 50-74 years of age in 2012 was 55.2%, ranging from 41.3% in the territories to 67.2% in the province of Manitoba. The rate for sigmoidoscopy or colonoscopy was 37.2% (highest in Ontario, at 43.3%), and for FOBT it was 30.1% (highest in Manitoba, at 51.7%). About 41% of those who had an FOBT also had a sigmoidoscopy or colonoscopy. Individuals in the highest income group were more likely than those in lower-income groups to be up to date with CRC screening, even in provinces with well-established population-based screening programs.Interpretation: More than half of Canadians were up to date with CRC screening in 2012, but there were large differences among provinces. Differences by income group in provinces with population-based screening programs need particular attention. Abstract E150CMAJ OPEN, 3(2)

show abstract

“…There are also disparities in the quality of the data between urban and rural areas of Brazilian states as well as in cities of smaller and larger populations [31]. While the quality of death notices and the percentage of under-reporting in Brazil seems to be improving in most states, the results reported for some regions still must be considered with caution, as the proportion of improperly defined causes of death can reach 10% in the Northern and Northeastern states of Brazil, leading to an underestimation of the mortality rates [32, 33]. Finally, the findings must be treated carefully in order to avoid the ecological fallacy of using aggregate results to make any inferences at the individual level.…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic differentials and mortality from colorectal cancer in large cities in Brazil

Parreira

Meira

Guimarães

2016

ecancer

View full text Add to dashboard Cite

The objective of this study was to compare the mortality pattern of colorectal cancer according to the social development profile of the large Brazilian cities. This was an ecological study that used as units of analysis Brazilian municipalities that were considered to be large (i.e. over 100,000 inhabitants). The social indicators adopted were obtained from the Atlas of Human Development in Brazil. Mortality data came from the Mortality Information System (MIS), represented by codes C18, C19, and C20. For data analysis, municipalities were characterised according to the indicator profile used by multivariate classification cluster analysis. It was observed that the Southeast, South, and Midwest regions concentrated over 90% of cities in the group of more developed municipalities, while the North and Northeast regions were represented by 60% of cities in the group of less developed municipalities. The mortality pattern of colorectal cancer in both groups was different, with a higher average mortality rate from colorectal cancer for populations living in cities from the more developed group (p = 0.02). The mortality rate from this cancer was shown to be directly proportional to the Municipal Human Developlemnt Index (MHDI) and inversely proportional to the inequality indicator (p < 0.001); therefore the highest means were observed among the municipalities with better socioeconomic conditions. It is important to consider social disparities to ensure equity in healthcare policy management.

show abstract

Geographical Variation and Factors Associated with Colorectal Cancer Mortality in a Universal Health Care System

Cited by 23 publications

References 21 publications

Geographic variation and factors associated with colorectal cancer incidence in Manitoba

Geographic variation and factors associated with colorectal cancer incidence in Manitoba

Screening rates for colorectal cancer in Canada: a cross-sectional study

Socioeconomic differentials and mortality from colorectal cancer in large cities in Brazil

Contact Info

Product

Resources

About