Are there socio-economic inequalities in age of resection of colorectal cancer in people with HNPCC?
The relationship between socio-economic status and health has been consistently reported and is thought to be causal. Socio-economic inequalities are present in the incidence of and mortality from cancer in general, but not in the incidence of colorectal cancer in particular. However, there are socio-economic gradients in mortality from colorectal cancer. The socio-economic distribution of incidence of and mortality from colorectal cancer in individuals with hereditary non-polyposis colon cancer (Lynch syndrome) is not known. It is possible that increased awareness of and access to screening for colorectal cancer amongst this group of individuals reduces the socio-economic gradients seen in the population as a whole. We investigated the relationship between socio-economic status and age of resection of colorectal cancer in a cohort of individuals with hereditary non-polyposis colon cancer. More affluent individuals tended to undergo surgical resection for colorectal cancers earlier in their lives than less affluent individuals. This relationship was bordering on statistical significance. This trend probably represents socio-economic variations in access to treatment. In addition, age based diagnostic criteria for hereditary non-polyposis colon cancer may, inadvertently, accentuate socio-economic inequalities in outcome.
Adams
Jean
J
School of Population and Health Sciences, University of Newcastle upon Tyne, UK. j.m.adams@ncl.ac.uk
White
Martin
M
Barker
Gail
G
Mathers
John
J
Burn
John
J
D000328:Adult; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D015331:Cohort Studies; D003082:Colectomy / Q000592:standards / Q000639:trends; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000592:standards / Q000639:trends; D008875:Middle Aged; D011336:Probability; D012042:Registries; D012307:Risk Factors; D012923:Social Class; D012959:Socioeconomic Factors; D016019:Survival Analysis; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology