Colorectal cancer, screening and survival: the influence of socio-economic deprivation.
OBJECTIVE
To determine the extent to which socio-economic deprivation explains colorectal cancer prevalence, subject participation in screening, and postoperative survival and life expectancy.


METHODS
Regression analyses of clinical data from a large randomized controlled trial, augmented by geographical-based indices of deprivation.


RESULTS
Deprivation appears to exert no significant impact on colorectal cancer prevalence but is a major factor explaining subject participation in screening. Cancer detection at later stages reduces life expectancy at time of treatment. Females from more-deprived areas have poorer post-treatment life expectancies and survival prospects, independently of their screening behaviour.


CONCLUSIONS
Screening increases the chances of having a cancer treated at an earlier stage, and treatment at an earlier stage is associated with longer subsequent life expectancy. However, those from more-deprived areas are less likely to accept an invitation to be screened.
Whynes
D K
DK
School of Economics, University of Nottingham, Nottingham NG7 2RD, UK. david.whynes@nottingham.ac.uk
Frew
E J
EJ
Manghan
C M
CM
Scholefield
J H
JH
Hardcastle
J D
JD
D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000191:economics / Q000401:mortality*; D019992:Databases as Topic; D004739:England / Q000453:epidemiology; D005194:Family Practice; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D011203:Poverty / Q000706:statistics & numerical data*; D015995:Prevalence; D016016:Proportional Hazards Models; D012923:Social Class; D012959:Socioeconomic Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D035862:Vulnerable Populations / Q000706:statistics & numerical data*