scholarly journals Socioeconomic gaps over time in colorectal cancer survival in England: flexible parametric survival analysis

2021 ◽  
pp. jech-2021-216754
Author(s):  
Mari Kajiwara Saito ◽  
Manuela Quaresma ◽  
Helen Fowler ◽  
Sara Benitez Majano ◽  
Bernard Rachet
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Cancer Survival ◽  
Population Based ◽  
Net Survival ◽  
Colorectal Cancer Survival ◽  
Emergency Presentation ◽  
Colon And Rectal Cancer ◽  
Time Varying Covariates ◽  
Over Time

BackgroundDespite persistent reports of socioeconomic inequalities in colorectal cancer survival in England, the magnitude of survival differences has not been fully evaluated.MethodsPatients diagnosed with colon cancer (n=68 169) and rectal cancer (n=38 267) in England (diagnosed between January 2010 and March 2013) were analysed as a retrospective cohort study using the National Cancer Registry data linked with other population-based healthcare records. The flexible parametric model incorporating time-varying covariates was used to assess the difference in excess hazard of death and in net survival between the most affluent and the most deprived groups over time.ResultsSurvival analyses showed a clear pattern by deprivation. Hazard ratio of death was consistently higher in the most deprived group than the least deprived for both colon and rectal cancer, ranging from 1.08 to 1.17 depending on the model. On the net survival scale, the socioeconomic gap between the most and the least deprived groups reached approximately −4% at the maximum (−3.7%, 95% CI −1.6 to −5.7% in men, −3.6%, 95% CI −1.6 to −5.7% in women) in stages III for colon and approximately −2% (−2.3%, 95% CI −0.2 to −4.5% in men, −2.3%, 95% CI −0.2 to −4.3% in women) in stage II for rectal cancer at 3 years from diagnosis, after controlling for age, emergency presentation, receipt of resection and comorbidities. The gap was smaller in other stages and sites. For both cancers, patients with emergency presentation persistently had a higher excess hazard of death than those without emergency presentation.ConclusionSurvival disparities were profound particularly among patients in the stages, which benefit from appropriate and timely treatment. For the patients with emergency presentation, excess hazard of death remained high throughout three years from the diagnosis. Public health measures should be taken to reduce access inequalities to improve survival disparities.

scholarly journals Colon and rectal cancer survival in seven high-income countries 2010–2014: variation by age and stage at diagnosis (the ICBP SURVMARK-2 project)

Gut ◽  
2020 ◽  
Vol 70 (1) ◽  
pp. 114-126 ◽  
Author(s):  
Marzieh Araghi ◽  
Melina Arnold ◽  
Mark J Rutherford ◽  
Marianne Grønlie Guren ◽  
Citadel J Cabasag ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Metastatic Disease ◽  
Cancer Survival ◽  
Cancer Registries ◽  
High Income ◽  
Cancer Registration ◽  
Stage At Diagnosis ◽  
Net Survival ◽  
Colon And Rectal Cancer ◽  
Staging Systems

ObjectivesAs part of the International Cancer Benchmarking Partnership (ICBP) SURVMARK-2 project, we provide the most recent estimates of colon and rectal cancer survival in seven high-income countries by age and stage at diagnosis.MethodsData from 386 870 patients diagnosed during 2010–2014 from 19 cancer registries in seven countries (Australia, Canada, Denmark, Ireland, New Zealand, Norway and the UK) were analysed. 1-year and 5-year net survival from colon and rectal cancer were estimated by stage at diagnosis, age and country,Results(One1-year) and 5-year net survival varied between (77.1% and 87.5%) 59.1% and 70.9% and (84.8% and 90.0%) 61.6% and 70.9% for colon and rectal cancer, respectively. Survival was consistently higher in Australia, Canada and Norway, with smaller proportions of patients with metastatic disease in Canada and Australia. International differences in (1-year) and 5-year survival were most pronounced for regional and distant colon cancer ranging between (86.0% and 94.1%) 62.5% and 77.5% and (40.7% and 56.4%) 8.0% and 17.3%, respectively. Similar patterns were observed for rectal cancer. Stage distribution of colon and rectal cancers by age varied across countries with marked survival differences for patients with metastatic disease and diagnosed at older ages (irrespective of stage).ConclusionsSurvival disparities for colon and rectal cancer across high-income countries are likely explained by earlier diagnosis in some countries and differences in treatment for regional and distant disease, as well as older age at diagnosis. Differences in cancer registration practice and different staging systems across countries may have impacted the comparisons.

Racial disparities in colorectal cancer survival: A population-based cohort.

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. e15643-e15643
Author(s):  
Muneer J Al-Husseini ◽  
Anas M Saad ◽  
Mohamed M Gad ◽  
Ahmad Rachid ◽  
Ahmed H. Salama ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Racial Disparities ◽  
Cancer Survival ◽  
Population Based ◽  
Colorectal Cancer Survival

Colorectal cancer survival— population-based rates in the province of Florence

1996 ◽  
Vol 5 (3) ◽  
pp. 189-196 ◽  
Author(s):  
E Crocetti ◽  
A Barchielli ◽  
E Buiatti ◽  
G Castiglione ◽  
M Zappa
Keyword(s):  
Colorectal Cancer ◽  
Cancer Survival ◽  
Population Based ◽  
Colorectal Cancer Survival

scholarly journals Socioeconomic Inequalities in Colorectal Cancer Survival in Southern Spain: A Multilevel Population-Based Cohort Study

2020 ◽  
Vol Volume 12 ◽  
pp. 797-806
Author(s):  
Miguel Angel Luque-Fernandez ◽  
Daniel Redondo-Sanchez ◽  
Miguel Rodriguez-Barranco ◽  
Chang-Chan Yoe-Ling ◽  
Elena Salamanca-Fernandez ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cohort Study ◽  
Cancer Survival ◽  
Population Based ◽  
Socioeconomic Inequalities ◽  
Southern Spain ◽  
Colorectal Cancer Survival

scholarly journals Changes in the quality of care of colorectal cancer in Estonia: a population-based high-resolution study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e035556
Author(s):  
Heigo Reima ◽  
Jaan Soplepmann ◽  
Anneli Elme ◽  
Mari Lõhmus ◽  
Rena Tiigi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Clinical Data ◽  
Population Based ◽  
Treatment Patterns ◽  
Stage Iii ◽  
Liver Imaging ◽  
Colon And Rectal Cancer ◽  
Incident Cases

ObjectivesLarge disparities in colorectal cancer (CRC) management and survival have been observed across Europe. Despite recent increases, the survival deficit of Estonian patients with CRC persists, particularly for rectal cancer. The aim of this study was to examine diagnostic, staging and treatment patterns of CRC in Estonia, comparing clinical data from 1997 and 2011.DesignNationwide population-based retrospective study.SettingEstonia.ParticipantsAll incident cases of colon and rectal cancer diagnosed in 1997 and 2011 identified from the Estonian Cancer Registry. Clinical data gathered from medical records.Outcome measuresDifferences in diagnostic, staging and treatment patterns; 5-year relative survival ratios.ResultsThe number of colon cancer cases was 337 in 1997 and 498 in 2011; for rectal cancer, the respective numbers were 209 and 349. From 1997 to 2011, large increases were seen in the use of colonoscopy and lung and liver imaging. Radical resection rate increased from 48% to 59%, but emergency surgeries showed a rise from 18% to 26% in colon and from 7% to 14% in rectal cancer. The proportion of radically operated patients with ≥12 lymph nodes examined pathologically increased from 2% to 58% in colon cancer and from 2% to 50% in rectal cancer. The use of neoadjuvant radiotherapy increased from 6% to 39% among stage II and from 20% to 50% among patients with stage III rectal cancer. The use of adjuvant chemotherapy in stage III colon cancer increased from 42% to 63%. The 5-year RSR increased from 50% to 58% in colon cancer and from 37% to 64% in patients with rectal cancer.ConclusionsMajor improvements were seen in the diagnostics, staging and treatment of CRC in Estonia contributing to better outcomes. Increase in emergency surgeries highlights possible shortcomings in timely diagnosis and treatment.

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