Sturley, C. orcid.org/0000-0001-8415-352X, Norman, P. orcid.org/0000-0002-6211-1625, Morris, M. et al. (1 more author) (Cover date: September 2023) Contrasting socio-economic influences on colorectal cancer incidence and survival in England and Wales. Social Science & Medicine, 333. 116138. ISSN 0277-9536
Abstract
Colorectal cancer (CRC) is the third most commonly diagnosed cancer in the world and second most common cause of cancer death. The relationship between socio-economic deprivation and CRC incidence is unclear and previous findings have been inconsistent. There is stronger evidence of an association between area-level deprivation and CRC survival; however, few studies have investigated the association between individual-level socio-economic status (SES) and CRC survival.
Data from the Office for National Statistics Longitudinal Study (LS) in England and Wales was used. LS members aged 50+ were stratified by individual-level educational attainment, social class, housing tenure and area deprivation quintile, measured at the 2001 Census. Time-to-event analysis examined associations between indicators of SES and CRC incidence and survival (all-cause and CRC death), over a 15-year follow-up period.
Among 178116 LS members, incidence of CRC was lower among those with a degree, compared to those with no degree and higher among those employed in manual occupations compared to non-manual occupations. No clear relationship was observed between CRC incidence and the area-based measure of deprivation.
Disparities were greater for survival. Among 5016 patients diagnosed with CRC aged 50+, probability of death from all-causes was lower among those with a degree, compared to no degree and higher among those employed in manual occupations, compared to non-manual occupations and among those living in social-rented housing, compared to owner-occupiers. Individual indicators of SES were also associated with probability of death from CRC. Those living in the most deprived areas had a higher probability of death (from all-causes and CRC) compared to those in the least deprived areas.
Both individual and area-based indicators of SES were associated with CRC survival, and the relationships were stronger than those observed for CRC incidence. These findings could help inform more effective targeting of public health interventions for CRC.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
Keywords: | Cancer, Colorectal cancer, Socioeconomic status, Deprivation, Longitudinal data, Survival analysis |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Medical Research (LIMR) > Division of Pathology and Data Analytics The University of Leeds > Faculty of Environment (Leeds) > School of Geography (Leeds) > Centre for Spatial Analysis & Policy (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 22 Aug 2023 10:07 |
Last Modified: | 22 Aug 2023 10:07 |
Published Version: | https://www.sciencedirect.com/science/article/pii/... |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.socscimed.2023.116138 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:202377 |