Socio-economic inequalities in cancer survival: how do they translate into Number of Life-Years Lost?

Abstract

Background We aimed to investigate the impact of socio-economic inequalities in cancer survival in England on the Number of Life-Years Lost (NLYL) due to cancer. Methods We analysed 1.2 million patients diagnosed with one of the 23 most common cancers (92.3% of all incident cancers in England) between 2010 and 2014. Socio-economic deprivation of patients was based on the income domain of the English Index of Deprivation. We estimated the NLYL due to cancer within 3 years since diagnosis for each cancer and stratified by sex, age and deprivation, using a non-parametric approach. The relative survival framework enables us to disentangle death from cancer and death from other causes without the information on the cause of death. Results The largest socio-economic inequalities were seen mostly in adults <45 years with poor-prognosis cancers. In this age group, the most deprived patients with lung, pancreatic and oesophageal cancer lost up to 6 additional months within 3 years since diagnosis than the least deprived. For most moderate/good prognosis cancers, the socio-economic inequalities widened with age. Conclusions More deprived patients and particularly the young with more lethal cancers, lose systematically more life-years than the less deprived. To reduce these inequalities, cancer policies should systematically encompass the inequities component.

Association between socio-economic status and non-communicable disease risk in young adults from Kenya, South Africa, and the United Kingdom

“…Our current findings in the UK sample corroborate other findings reported in the UK and other HICs 15 , 17 , 31 , 32 , in which lower SES groups have unfavourable health outcomes including a greater risk of developing NCDs (i.e., cancer and CVD) and dying prematurely compared to their high SES counterparts. The exact mechanisms underlying the health inequalities in the UK are complex and include many aspects such as social, economic, and environmental determinants 33 .…”

Diagnosis, treatment, and survival from kidney cancer: real‐world National Health Service England data between 2013 and 2019

“…Survival outcomes did not differ by gender similar to previous reports of KC survival in England [50]. It was noted that survival rates worsened with increasing levels of deprivation; this is a consistent finding across all cancers [50,51]. However, many other factors, which are unavailable in this dataset could influence this, such as, KC Stage and competing comorbidity.…”

“…Survival outcomes did not differ by gender similar to previous reports of KC survival in England [50]. It was noted that survival rates worsened with increasing levels of deprivation; this is a consistent finding across all cancers [50,51].…”

Socioeconomic inequalities in cancer mortality between and within countries in Europe: a population-based study

“…3 Wherever data are available, individuals with lower socioeconomic position—whether measured by education, occupational class, income or other indicators—are at disproportionally higher risk of dying from the most common forms of cancer, compared to their more advantaged fellow citizens. 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 The social gradient may nevertheless vary across countries, over time and for different cancer types.…”