Cancer survival in New South Wales, Australia: socioeconomic disparities remain despite overall improvements

open access

Background

Disparities in cancer survival by socioeconomic status have been reported previously in Australia. We investigated whether those disparities have changed over time.

 

Methods

We used population-based cancer registry data for 377,493 patients diagnosed with one of 10 major cancers in New South Wales (NSW), Australia. Patients were assigned to an area-based measure of socioeconomic status. Five-year relative survival was estimated for each socioeconomic quintile in each ‘at risk’ period (1996–2000 and 2004–2008) for the 10 individual cancers. Poisson-regression modelling was used to adjust for several prognostic factors. The relative excess risk of death by socioeconomic quintile derived from this modelling was compared over time.

 

Conclusion

While recent health and social policies in NSW have accompanied an increase in cancer survival overall, they have not been associated with a reduction in socioeconomic inequalities.

  Liver, breast, ovarian and prostate cancers saw higher case numbers in the less disadvantaged SES groups, whereas the opposite trend occurred for lung cancer.

 No significant variation in RER was found for melanoma, ovarian, cervix or uterine cancers.

 Melanoma and ovarian cancer again showed no significant variation in RER of death by SES in 2004–2008.

 Previous studies of ovarian cancer survival have also found no association with SES [6, 32]. The non-specific nature of symptoms and lack of a definitive screening-diagnostic test could explain this finding, as the majority of diagnoses in all socioeconomic groups in NSW in both periods occurred at an unknown or already advanced stage (Additional file 2: Table S2), by which point effective treatment options are limited [33].