gms | German Medical Science

MAINZ//2011: 56. GMDS-Jahrestagung und 6. DGEpi-Jahrestagung

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V.
Deutsche Gesellschaft für Epidemiologie e. V.

26. - 29.09.2011 in Mainz

An analysis on equity in cancer survival between population groups in a country where the survival is high

Meeting Abstract

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  • Timo Hakulinen - Finnish Cancer Registry, Helsinki, Finnland
  • Arun Pokhrel - Finnish Cancer Registry, Helsinki, Finnland

Mainz//2011. 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi). Mainz, 26.-29.09.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11gmds617

DOI: 10.3205/11gmds617, URN: urn:nbn:de:0183-11gmds6175

Published: September 20, 2011

© 2011 Hakulinen et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Background: Relative survival after cancer in Finland is at the highest level observed in Europe and has in general been in a steady increase. The aim of this study was to assess whether the high survival is equally shared by different population subgroups and to estimate the possible gains that might be achieved if equity prevailed.

Methods: The educational level and occupation prior to the cancer diagnosis of cancer patients diagnosed in Finland in 1971-2005 was derived from an antecedent population census. Cause-specific and relative five-year survival figures were calculated for population categories based on these variables. Numbers and proportions of avoidable deaths were derived under the assumption that the patients from two lower educational categories would have the same mortality due to cancer as those from the highest educational category. Moreover, estimates were made also on an additional assumption of equally high mortalities due to other causes of death in all of the three categories.

Results: For almost all 25 cancer sites considered in this study and both sexes the survival was consistently highest for patients with highest education and lowest for those with basic education only. Patients in health-consciousness-related occupations (physician, nurse, teacher etc.) had an even higher survival. A part of the differences was attributable to a less favourable distribution of tumour stages in the lower education categories. In 1996-2005, 4-7% of the deaths in the Finnish cancer patients could be avoided during the first five-year period after diagnosis, should all the patients have the same cancer mortality as the patients with the highest educational background. The proportion would be much higher, 8-11%, if also the mortality from other causes were the same as that in the highest educational category.

Discussion: Higher cancer patient survival among the highest educated may be related to differences in personal habits and ways of life but it is also related to an earlier cancer diagnosis. Ability to cope within the health care system may also be relevant.


References

1.
Pokhrel A, Martikainen P, Pukkala E, Rautalahti M, Seppä K, Hakulinen T. Education, survival and avoidable deaths in cancer patients in Finland. Brit J Cancer. 2010;103:1109-14.