title: Colorectal cancer survival in socioeconomic groups in England: variation is mainly in the short term after diagnosis.
abstract: The objective of this study was to examine differences in cancer survival between socioeconomic groups in England, with particular attention to survival in the short term of follow-up.
  
  
  METHODS
  Individuals diagnosed with colorectal cancer between 1996 and 2004 in England were identified from cancer registry records. Five-year cumulative relative survival and excess death rates were computed.
  
  
  RESULTS
  For colon cancer there was a very high excess death rate in the first month of follow-up, and the excess death rate was highest in the socioeconomically deprived groups. In subsequent periods, excess mortality rates were much lower and there was less socioeconomic variation. The pattern of variation in excess death rates was generally similar in rectal cancer but the socioeconomic difference in death rates persisted several years longer. If the excess death rates in the entire colorectal cancer patient population were the same as those observed in the most affluent socioeconomic quintile, the annual reduction would be 360 deaths in colon cancer and 336 deaths in rectal cancer patients. These deaths occurred almost entirely in the first month and the first year after diagnosis.
  
  
  CONCLUSIONS
  Recent developments in the national cancer control agenda have included an increasing emphasis on outcome measures, with short-term cancer survival an operational measure of variation and progress in cancer control. In providing clues to the nature of the survival differences between socioeconomic groups, the results presented here give strong support for this strategy.
authors.affiliation: King's College London, Thames Cancer Registry, 1st Floor Capital House, 42 Weston Street, London SE1 3QD, UK. henrik.moller@kcl.ac.uk
authors.forename: Henrik
authors.initials: H
authors.lastname: Møller
authors.forename: Fredrik
authors.initials: F
authors.lastname: Sandin
authors.forename: David
authors.initials: D
authors.lastname: Robinson
authors.forename: Freddie
authors.initials: F
authors.lastname: Bray
authors.forename: Sa
authors.initials: S
authors.lastname: Klint
authors.forename: Karen M
authors.initials: KM
authors.lastname: Linklater
authors.forename: Paul C
authors.initials: PC
authors.lastname: Lambert
authors.forename: Lars
authors.initials: L
authors.lastname: Påhlman
authors.forename: Lars
authors.initials: L
authors.lastname: Holmberg
authors.forename: Eva
authors.initials: E
authors.lastname: Morris
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000401:mortality*; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012923:Social Class; D016019:Survival Analysis; D013997:Time Factors; D055815:Young Adult