Socio‐economic deprivation and survival in bladder cancer

Abstract

OBJECTIVESTo investigate the relationship between deprivation, delay and survival from bladder cancer in the West Midlands, as socio‐economic deprivation is associated with worse survival in many malignancies, and it has been suggested that treatment differences and delay in seeking care are major contributing causes.PATIENTS AND METHODSData were prospectively collected on 1537 newly diagnosed cases of urothelial cancer presenting in the West Midlands between January 1991 and June 1992. Survival was censored at 31 July 2000, when 785 (51%) patients had died. The influence of deprivation on survival was explored using cause‐specific and all‐cause mortality.RESULTSPatients in less affluent groups had significantly worse survival than patients in more affluent groups when considering deaths from all causes (P = 0.02), which held true when adjusting for independent prognostic factors (age, smoking history, and tumour grade, stage, type and size). Bladder cancer‐specific mortality showed no significant difference between socio‐economic groups (P = 0.30).CONCLUSIONSocio‐economic deprivation is a significant predictor of survival when death from all causes is considered. However, this does not hold true for bladder cancer‐specific death. The perceived differences in treatment and delay between socio‐economic groups do not seem to occur for bladder cancer in the West Midlands.

Effect of socioeconomic status on stage at diagnosis of lung cancer in a hospital‐based multicenter retrospective clinical epidemiological study in China, 2005–2014

“…7 Infant mortality rate (‰) only for 2010 (mean). 8 Following the principle component analysis, the two factors extracted from the variables were retained with eigenvalue ≥ 1.0, which can explain 79.9% of the variance.…”

“…In China, highly unequal distribution of insurance benefits still exists under the current social health insurance programs, especially for the vulnerable groups such as children, women, low-income, and rural population [2,3]. The possible underlying causes of the different cancer outcomes among social groups include health care provision according to socioeconomic areas [4][5][6], health-related behaviors of individuals [7,8], and environmental or occupational exposures across socioeconomic groups [9][10][11]. Up to now, there is inconsistent evidence of the association between socioeconomic status (SES) and lung cancer stage from the current studies in non-Chinese populations.…”

Association between insurance and socioeconomic status and risk of advanced stage Hodgkin lymphoma in adolescents and young adults

“…Aside from the association between insurance status and SES and being diagnosed with advanced disease, comorbidities and health behaviors may also influence outcomes. There is evidence that smoking among cancer patients varies with SES 26. Such differentials in high‐risk behaviors may then lead to poorer health status and comorbidities.…”

Outcomes of radical cystectomy

“…In a study by Begum et al. [89] socio‐economic deprivation was a significant predictor of survival when death from all causes was considered, but this did not hold true for bladder cancer‐specific death.…”