Socioeconomic disparities in cancer survival: Relation to stage at diagnosis, treatment, and centralization of patients to accredited hospitals, 2005–2014, Japan

Odani, Satomi; Tabuchi, Takahiro; Nakaya, Tomoki; Morishima, Toshitaka; Nakata, Kayo; Kuwabara, Yoshihiro; Saito, Mari; Ma, Chaochen; Miyashiro, Isao

doi:10.1002/cam4.5332

Cited by 5 publications

(3 citation statements)

References 30 publications

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“…Furthermore, as the deprivation index increased, the risk of death also increased. This trend has also been observed in studies conducted in Japan and the United States [ 23 24 ]. However, this finding may differ from that of domestic studies.…”

Section: Discussionsupporting

confidence: 76%

“…Notably, for relatively preventable cancers such as cervical cancer, the mortality rate in the low-income group was twice that of the high-income group, whereas disparities in mortality rates for lung and liver cancers were comparatively narrower [ 11 ]. Furthermore, studies from Japan and the United States have found a correlation between measuring SES levels using the regional deprivation index and the risk of cancer mortality [ 23 24 ]. However, a similar relationship was not identified in a Korean study [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

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Socioeconomic Disparities in Six Common Cancer Survival Rates in South Korea: Population-Wide Retrospective Cohort Study

Lee,

Park,

Kim

et al. 2024

JMIR Public Health Surveill

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Background In South Korea, the cancer incidence rate has increased by 56.5% from 2001 to 2021. Nevertheless, the 5-year cancer survival rate from 2017 to 2021 increased by 17.9% compared with that from 2001 to 2005. Cancer survival rates tend to decline with lower socioeconomic status, and variations exist in the survival rates among different cancer types. Analyzing socioeconomic patterns in the survival of patients with cancer can help identify high-risk groups and ensure that they benefit from interventions. Objective The aim of this study was to analyze differences in survival rates among patients diagnosed with six types of cancer—stomach, colorectal, liver, breast, cervical, and lung cancers—based on socioeconomic status using Korean nationwide data. Methods This study used the Korea Central Cancer Registry database linked to the National Health Information Database to follow up with patients diagnosed with cancer between 2014 and 2018 until December 31, 2021. Kaplan-Meier curves stratified by income status were generated, and log-rank tests were conducted for each cancer type to assess statistical significance. Hazard ratios with 95% CIs for any cause of overall survival were calculated using Cox proportional hazards regression models with the time since diagnosis. Results The survival rates for the six different types of cancer were as follows: stomach cancer, 69.6% (96,404/138,462); colorectal cancer, 66.6% (83,406/125,156); liver cancer, 33.7% (23,860/70,712); lung cancer, 30.4% (33,203/109,116); breast cancer, 91.5% (90,730/99,159); and cervical cancer, 78% (12,930/16,580). When comparing the medical aid group to the highest income group, the hazard ratios were 1.72 (95% CI 1.66‐1.79) for stomach cancer, 1.60 (95% CI 1.54‐1.56) for colorectal cancer, 1.51 (95% CI 1.45‐1.56) for liver cancer, 1.56 (95% CI 1.51‐1.59) for lung cancer, 2.19 (95% CI 2.01‐2.38) for breast cancer, and 1.65 (95% CI 1.46‐1.87) for cervical cancer. A higher deprivation index and advanced diagnostic stage were associated with an increased risk of mortality. Conclusions Socioeconomic status significantly mediates disparities in cancer survival in several cancer types. This effect is particularly pronounced in less fatal cancers such as breast cancer. Therefore, considering the type of cancer and socioeconomic factors, social and medical interventions such as early cancer detection and appropriate treatment are necessary for vulnerable populations.

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Section: Discussionsupporting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Socioeconomic Disparities in Six Common Cancer Survival Rates in South Korea: Population-Wide Retrospective Cohort Study

Lee,

Park,

Kim

et al. 2024

JMIR Public Health Surveill

View full text Add to dashboard Cite

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“…Moreover, an investigation of socioeconomic inequalities in cancer incidence and survival rate is also required to clarify the overall picture of the cancer burden. 29 …”

Section: Discussionmentioning

confidence: 99%

Educational inequalities in all-cause and cause-specific mortality in Japan: national census-linked mortality data for 2010–15

Tanaka,

Katanoda,

Togawa

et al. 2024

International Journal of Epidemiology

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Background Due to the lack of a national mortality inequality monitoring framework, the overall picture in Japan remains unclear. Here, we investigated educational inequalities in mortality and their cause-specific contribution in Japan. Method Data were obtained by linking the 2010 Japanese population census and death records between 1 October 2010 and 30 September 2015. We included 7 984 451 Japanese people aged 30–79 years who had a unique ‘matching key’ generated by sex, birth year/month, address (municipality), marital status and age of spouse (9.9% of the total census population). We computed population-weighted all-cause and cause-specific age-standardized mortality rates (ASMRs) by education level. In addition, we calculated the slope index of inequality (SII), relative index inequality (RII) by education level, and population attributable fraction (PAF) referenced with the highest education (e.g. university graduation). Results Individuals with less education had higher all-cause and cause-specific ASMRs than highly educated individuals. All-cause SII (per 100 000 person-years) values were 433 (95% CI: 410–457) for men and 235 (95% CI: 217–252) for women. RII values were 1.48 (95% CI: 1.45–1.51) for men and 1.47 (95% CI: 1.43–1.51) for women. Estimated PAFs, excess premature deaths caused by educational inequalities, were 11.6% for men and 16.3% for women, respectively. Cerebrovascular diseases, ischaemic heart diseases and lung cancer were the major contributors to mortality inequalities for both sexes. Conclusions This first census-based comprehensive report on cause-specific educational mortality inequalities suggested that differences in unfavourable health risk factors by educational background might be associated with these inequalities in Japan.

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