Differences in cancer survival by remoteness of residence: an analysis of data from a population-based cancer registry
- PDF / 1,068,329 Bytes
- 13 Pages / 595.276 x 790.866 pts Page_size
- 107 Downloads / 169 Views
ORIGINAL PAPER
Differences in cancer survival by remoteness of residence: an analysis of data from a population‑based cancer registry Nina Afshar1,2 · Dallas R. English1,2 · James A. Chamberlain1 · Tony Blakely2 · Vicky Thursfield4 · Helen Farrugia4 · Graham G. Giles1,2,3 · Roger L. Milne1,2,3 Received: 7 November 2019 / Accepted: 15 April 2020 © Springer Nature Switzerland AG 2020
Abstract Purpose Cancer survival is generally lower for rural compared with urban residents, but findings have been inconsistent. We aimed to assess inequalities in cancer survival by remoteness of residence in Victoria, Australia. Methods Incident cancer cases diagnosed in 2001–2015 with 30 cancer types (n = 331,302) were identified through the Victorian Cancer Registry and followed to the end of 2015 through death registries. Five-year net survival was estimated using the Pohar–Perme method and differences assessed by excess mortality rate ratios (EMRRs) using Poisson regression, adjusting for sex, age and year of diagnosis. EMRRs adjusted for socio-economic disadvantage were also estimated. Results People living outside major cities had lower survival for 11 cancers: esophagus, stomach, colorectum, liver, gallbladder/biliary tract, pancreas, lung, connective/soft tissue, ovary, prostate, kidney. No differences in survival were found for cancers of uterus, small intestine and mesothelioma. After adjusting for socio-economic disadvantage, the observed differences in survival decreased for most cancers and disappeared for colorectal cancer, but they remained largely unchanged for cancers of esophagus, stomach, liver, pancreas, lung, connective/soft tissue, ovary and kidney. Conclusion People with cancer residing outside major cities had lower survival from some cancers, which is partly due to the greater socio-economic disadvantage of rural residents. Keywords Rural · Urban · Inequalities · Cancer survival · Excess mortality · Survival analysis
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10552-020-01303-2) contains supplementary material, which is available to authorized users. * Nina Afshar [email protected] 1
Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC 3004, Australia
2
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC 3010, Australia
3
Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC 3168, Australia
4
Victorian Cancer Registry, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC 3004, Australia
Cancer survival is increasing in Western countries because of earlier diagnosis and more effective treatment, and Australia is among the four high-income countries with the highest survival for most cancers [1, 2]. Our recent systematic review showed that several studies have reported inequalities in cancer survival between rural and ur
Data Loading...
