Poverty gap for cancer survival widens
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《英国医生杂志》
London
The poverty gap for cancer survival in England and Wales widened throughout the 1990s, despite official efforts to help poor patients to access the best care, a government backed analysis of patient records shows.
Reporting in an advance online publication in the British Journal of Cancer this week (www.nature.com), the researchers found that poor men and women have a significantly lower chance of surviving almost two in three of the most common cancers than their richer counterparts. And that gap is widening, according to the research, funded by the Office for National Statistics and leading cancer charity Cancer Research UK.
"There's been an increase in survival for almost all of the cancers, but for 28 of the 33 cancer-sex combinations there's a substantial difference between rich and poor, and it's getting worse," said lead author Professor Michel Coleman, an epidemiologist from the London School of Hygiene and Tropical Medicine.
Researchers used records from national cancer registries for 2.2 million patients across England and Wales who were diagnosed with one of the 20 most common cancers between 1986 and 1999. Each patient was assigned to one of five socioeconomic categories—from "affluent" to "deprived"—on the basis of the electoral ward they lived in at the time of diagnosis.
Subdividing the cancers by sex showed that for 20 out of 33 types of cancer, living in a poor area reduced a patient's survival chances to a significant degree.
Researchers compared survival rates in three cohorts: the first diagnosed during 1986-90; the second during 1991-5; and the third during 1996-9, the period just before publication of the NHS Cancer Plan.
Professor Coleman called for a colorectal screening programme that targets poor people, more research to find out how accessible cancer services are for rich versus poor, and more training to help GPs to spot cancers earlier.
"We should get everybody diagnosed as early as possible. We should also ensure that when patients are seen in hospital they all have equitable access to optimal investigations and treatment and do so with a multidisciplinary team," he said. "Having been a GP, I can tell you that a typical GP will see somewhere between six and eight patients a year with cancer. That's not a lot, and detecting the rare ... is a tough job."
The analysis shows the deprivation gap is widening to a significant degree for men with cancers of the oesophagus, colon, rectum, larynx, or prostate and for women, with colon cancer, rectal cancer, or myeloma.(Katherine Burke)
The poverty gap for cancer survival in England and Wales widened throughout the 1990s, despite official efforts to help poor patients to access the best care, a government backed analysis of patient records shows.
Reporting in an advance online publication in the British Journal of Cancer this week (www.nature.com), the researchers found that poor men and women have a significantly lower chance of surviving almost two in three of the most common cancers than their richer counterparts. And that gap is widening, according to the research, funded by the Office for National Statistics and leading cancer charity Cancer Research UK.
"There's been an increase in survival for almost all of the cancers, but for 28 of the 33 cancer-sex combinations there's a substantial difference between rich and poor, and it's getting worse," said lead author Professor Michel Coleman, an epidemiologist from the London School of Hygiene and Tropical Medicine.
Researchers used records from national cancer registries for 2.2 million patients across England and Wales who were diagnosed with one of the 20 most common cancers between 1986 and 1999. Each patient was assigned to one of five socioeconomic categories—from "affluent" to "deprived"—on the basis of the electoral ward they lived in at the time of diagnosis.
Subdividing the cancers by sex showed that for 20 out of 33 types of cancer, living in a poor area reduced a patient's survival chances to a significant degree.
Researchers compared survival rates in three cohorts: the first diagnosed during 1986-90; the second during 1991-5; and the third during 1996-9, the period just before publication of the NHS Cancer Plan.
Professor Coleman called for a colorectal screening programme that targets poor people, more research to find out how accessible cancer services are for rich versus poor, and more training to help GPs to spot cancers earlier.
"We should get everybody diagnosed as early as possible. We should also ensure that when patients are seen in hospital they all have equitable access to optimal investigations and treatment and do so with a multidisciplinary team," he said. "Having been a GP, I can tell you that a typical GP will see somewhere between six and eight patients a year with cancer. That's not a lot, and detecting the rare ... is a tough job."
The analysis shows the deprivation gap is widening to a significant degree for men with cancers of the oesophagus, colon, rectum, larynx, or prostate and for women, with colon cancer, rectal cancer, or myeloma.(Katherine Burke)