The association between neighborhood-level income and cancer stage at diagnosis and survival in Alberta.

Autor: Ruan Y; Forzani & MacPhail Colon Cancer Screening Centre, University of Calgary, Calgary, Alberta, Canada.; Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta, Canada., Heer E; Forzani & MacPhail Colon Cancer Screening Centre, University of Calgary, Calgary, Alberta, Canada.; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., Warkentin MT; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., Jarada TN; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., O'Sullivan DE; Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta, Canada.; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., Hao D; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., Ezeife D; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., Cheung W; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., Brenner DR; Forzani & MacPhail Colon Cancer Screening Centre, University of Calgary, Calgary, Alberta, Canada.; Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta, Canada.; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Jazyk: angličtina
Zdroj: Cancer [Cancer] 2024 Feb 15; Vol. 130 (4), pp. 563-575. Date of Electronic Publication: 2023 Nov 22.
DOI: 10.1002/cncr.35098
Abstrakt: Background: Socioeconomic status (SES) is associated with a range of health outcomes, including cancer diagnosis and survival. However, the evidence for this association is inconsistent between countries with and without single-payer health care systems. In this study, the relationships between neighborhood-level income, cancer stage at diagnosis, and cancer-specific mortality in Alberta, Canada, were evaluated.
Methods: The Alberta Cancer Registry was used to identify all primary cancer diagnoses between 2010 and 2020. Average neighborhood income was determined by linking the Canadian census to postal codes and was categorized into quintiles on the basis of income distribution in Alberta. Multivariable multinomial logistic regression was used to model the association between income quintile and stage at diagnosis, and the Fine-Gray proportional subdistribution hazards model was used to estimate the association between SES and cancer-specific mortality.
Results: Out of the 143,818 patients with cancer included in the study, those in lower income quintiles were significantly more likely to be diagnosed at stage III (odds ratio [OR], 1.07; 95% CI [confidence interval], 1.06-1.09) or IV (OR, 1.12; 95% CI, 1.11-1.14) after adjusting for age and sex. Lower income quintiles also had significantly worse cancer-specific survival for breast, colorectal, liver, lung, non-Hodgkin lymphoma, oral cavity, pancreas, and prostate cancers.
Conclusions: Disparities were observed in cancer outcomes across neighborhood-level income groups in Alberta, which demonstrates that health inequities by SES exist in countries with single-payer health care systems. Further research is needed to better understand the underlying causes and to develop strategies to mitigate these disparities.
(© 2023 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.)
Databáze: MEDLINE
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