Socioeconomic Environment and Survival in Patients with Digestive Cancers: A French Population-Based Study
- PMID: 34680305
- PMCID: PMC8533795
- DOI: 10.3390/cancers13205156
Socioeconomic Environment and Survival in Patients with Digestive Cancers: A French Population-Based Study
Abstract
Social inequalities are an important prognostic factor in cancer survival, but little is known regarding digestive cancers specifically. We aimed to provide in-depth analysis of the contextual social disparities in net survival of patients with digestive cancer in France, using population-based data and relevant modeling. Digestive cancers (n = 54,507) diagnosed between 2006-2009, collected through the French network of cancer registries, were included (end of follow-up 30 June 2013). Social environment was assessed by the European Deprivation Index. Multidimensional penalized splines were used to model excess mortality hazard. We found that net survival was significantly worse for individuals living in a more deprived environment as compared to those living in a less deprived one for esophageal, liver, pancreatic, colon and rectal cancers, and for stomach and bile duct cancers among females. Excess mortality hazard was up to 57% higher among females living in the most deprived areas (vs. least deprived) at 1 year of follow-up for bile duct cancer, and up to 21% higher among males living in the most deprived areas (vs. least deprived) regarding colon cancer. To conclude, we provide a better understanding of how the (contextual) social gradient in survival is constructed, offering new perspectives for tackling social inequalities in digestive cancer survival.
Keywords: French cancer registries; cancer net survival; deprivation; digestive cancers; social gradient.
Conflict of interest statement
The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.
Figures



References
-
- Marmot M., Allen J., Bell R., Bloomer E., Goldblatt P., Consortium for the European Review of Social Determinants of Health and the Health Divide WHO European review of social determinants of health and the health divide. Lancet. 2012;380:1011–1029. doi: 10.1016/S0140-6736(12)61228-8. - DOI - PubMed
-
- Nakaya T., Miyashiro I., Ito Y., Nakayama T., Ioka A., Tsukuma H., Rachet B. Socioeconomic inequalities in cancer survival: A population-based study of adult patients diagnosed in Osaka, Japan, during the period 1993–2004. Acta Oncol. 2014;53:1423–1433. doi: 10.6084/m9.figshare.1623063. - DOI - PubMed
Grants and funding
LinkOut - more resources
Full Text Sources