Absence of socioeconomic variation in survival from colorectal cancer in patients receiving surgical treatment in one health district: cohort study.
OBJECTIVE
To examine whether there is an association between patient deprivation status and survival from colorectal cancer among patients receiving treatment of the same type and quality.


METHODS
A survival study was conducted of all colorectal cancer patients diagnosed between 1991 and 1997 who received surgery either in the NHS district general hospital or the private hospital of one UK health district. The five-year survival rates, both all cause and colorectal cancer specific, were calculated for subgroups defined by patient age, gender, stage and deprivation status using Kaplan-Meier curves. Cox proportional hazards models were used to examine the influence of deprivation on five-year survival after adjusting for age, gender and stage.


RESULTS
There were 603 consecutive colorectal patients during the study period. Five-year all-cause and colorectal cancer-specific survival rates were 41% and 53%, respectively. There was no association between deprivation status and stage at diagnosis (P = 0.308). Multivariable proportional hazards modelling (adjusting for gender, age and tumour stage) demonstrated no association between deprivation status and survival.


CONCLUSIONS
In this single district study, no relationship between patient socioeconomic status and survival from colorectal cancer could be demonstrated. Consistency in the type and quality of treatment offered to patients by the same clinical teams may have been responsible for the equitable survival outcomes.
Lyratzopoulos
G
G
Evidence for Population Health Unit, School of Epidemiology and Health Sciences, University of Manchester, Manchester, UK. georgios.lyratzopoulos@nscstha.nhs.uk
Sheridan
G F
GF
Michie
H R
HR
McElduff
P
P
Hobbiss
J H
JH
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D015331:Cohort Studies; D003082:Colectomy / Q000379:methods / Q000401:mortality*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D016001:Confidence Intervals; D005260:Female; D016304:Hospitals, Private / Q000592:standards*; D006779:Hospitals, Public / Q000592:standards*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011203:Poverty; D011336:Probability; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D012923:Social Class; D012959:Socioeconomic Factors; D013222:State Medicine / Q000592:standards; D016019:Survival Analysis; D006113:United Kingdom / Q000453:epidemiology