Contrasting socio-economic influences on colorectal cancer incidence and survival in England and Wales

Bibliographic Data

ID4593397
AuthorsCharlotte Sturley (0000-0001-8415-352X, University of Leeds, corresponding author), Paul Norman (0000-0002-6211-1625, University of Leeds), Michelle Morris (0000-0002-9325-619X, University of Leeds), Ashleigh Downing (0000-0002-0335-7801, University of Leeds)
Year2023
Volume333
Pages116138
Publication date2023-09-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSocial Science & Medicine (JOURNAL)
Journal identifiersISSN: 0277-9536 • E-ISSN: 1873-5347
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2023.116138
PMID37579558
OpenAlexW4385496991
LanguageEN
Citations received6
References cited19

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

Cancer · Census · Colorectal cancer · Educational attainment · Environmental health · Incidence (geometry · Population · Social class · Social deprivation · Socioeconomic status · Colorectal Cancer Screening and Detection · Demography · Global Cancer Incidence and Screening · Global Health Care Issues · Medicine · Gerontology · Internal Medicine