title: Retrospective analysis of cancer survival across South-Western Victoria in Australia.
abstract: OBJECTIVE
  This paper aims to describe cancer survival and examine association between survival and socio-demographic characteristics across Barwon South-Western region (BSWR) in Victoria, Australia.
  
  
  METHODS
  This study is based on the retrospective cohort database of patients accessing oncology services across BSWR.
  
  
  METHODS
  Six rural and three urban hospital settings across the BSWR.
  
  
  METHODS
  The participants were patients who were diagnosed with cancer in 2009.
  
  
  METHODS
  Overall survival (OS) of participants was the main outcome measure.
  
  
  RESULTS
  Total of 1778 eligible patients had four-year OS for all cancers combined of 59.7% (95% CI, 57.4-62.0). Improved OS was observed for patients in the upper socio-economic tertile (64.2%; 95% CI, 60.9-67.5) compared to the middle (59.3%; 95% CI, 55.5-63.1) and lowest tertiles (49.6%; 95% CI, 44.2-54.9) (P < 0.01). On multivariate analyses, higher socio-economic status remained a significant predictor of OS adjusting for gender, remoteness and age (HR [hazard ratio] 0.81; 95% CI 0.74-0.89; P < 0.01). Remoteness was significantly associated with improved OS after adjusting for age, gender and socio-economic status (HR 0.86; 95% CI, 0.77-0.97; P = 0.01). Older age ≥70 years compared to <70 years conferred inferior OS (HR 3.08; 95% CI, 2.64-3.59; P < 0.01).
  
  
  CONCLUSIONS
  Our study confirmed improved survival outcomes for patients of higher socio-economic status and younger age. Future research to explain the unexpected survival benefit in patients who lived in more remote areas should examine factors including the correlation between geographical residence and eventual treatment facility as well as compare the BSWR care model to other regions' approaches.
authors.affiliation: Department of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia.|Andrew Love Cancer Centre, Barwon Health, Geelong, Victoria, Australia.
authors.forename: Shu Fen
authors.initials: SF
authors.lastname: Wong
authors.affiliation: Barwon South Western Regional Integrated Cancer Services, Geelong, Victoria, Australia.
authors.forename: Leigh
authors.initials: L
authors.lastname: Matheson
authors.affiliation: Barwon South Western Regional Integrated Cancer Services, Geelong, Victoria, Australia.
authors.forename: Kate
authors.initials: K
authors.lastname: Morrissy
authors.affiliation: Andrew Love Cancer Centre, Barwon Health, Geelong, Victoria, Australia.|Barwon South Western Regional Integrated Cancer Services, Geelong, Victoria, Australia.
authors.forename: Graham
authors.initials: G
authors.lastname: Pitson
authors.affiliation: Department of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia.|Andrew Love Cancer Centre, Barwon Health, Geelong, Victoria, Australia.|Barwon South Western Regional Integrated Cancer Services, Geelong, Victoria, Australia.
authors.forename: David M
authors.initials: DM
authors.lastname: Ashley
authors.affiliation: Andrew Love Cancer Centre, Barwon Health, Geelong, Victoria, Australia.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Khasraw
authors.affiliation: Centre of Health Economics, Monash University, Melbourne, Victoria, Australia.
authors.forename: Paula K
authors.initials: PK
authors.lastname: Lorgelly
authors.affiliation: Barwon South Western Regional Integrated Cancer Services, Geelong, Victoria, Australia.
authors.forename: Margaret J
authors.initials: MJ
authors.lastname: Henry
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality; D012189:Retrospective Studies; D012923:Social Class; D013534:Survival; D014739:Victoria / Q000453:epidemiology
keywords: mortality; neoplasm; rural health; socio-economic status; urban health