RT Journal Article
T1 Socioeconomic Inequalities in Colorectal Cancer Survival in Southern Spain: A Multilevel Population-Based Cohort Study.
A1 Luque-Fernandez, Miguel Angel
A1 Redondo-Sanchez, Daniel
A1 Rodriguez-Barranco, Miguel
A1 Chang-Chan, Yoe-Ling
A1 Salamanca-Fernandez, Elena
A1 Nuñez, Olivier
A1 Fernandez-Navarro, Pablo
A1 Pollan, Marina
A1 Sanchez-Perez, Maria-Jose
K1 colorectal cancer
K1 epidemiological methods
K1 multilevel
K1 population-based epidemiology
K1 socioeconomic inequalities
K1 survival
AB Colorectal cancer (CRC) is the most frequently diagnosed cancer in Spain. Socioeconomic inequalities in cancer survival are not documented in Spain. We aim to study the association of socioeconomic inequalities with overall mortality and survival among CRC patients in southern Spain. We conducted a multilevel population-based cohort study, including CRC cases for the period 2011-2013. The study time-to-event outcome was death, and the primary exposure was CRC patients' socioeconomic status assessed by the Spanish deprivation index at the census tract level. We used a mixed-effects flexible hazard model, including census tract as a random intercept, to derive overall survival estimates by deprivation. Among 3589 CRC patients and 12,148 person-years at risk (pyr), 964 patients died before the end of the follow-up. Mortality by deprivation showed the highest mortality rate for the most deprived group (96.2 per 1000 pyr, 95% CI: 84.0-110.2). After adjusting for sex, age, cancer stage, and the area of residence, the most deprived had a 60% higher excess mortality risk than the less deprived group (excess mortality risk ratio: 1.6, 95% CI: 1.1-2.3). We found a consistent association between deprivation and CRC excess mortality and survival. The reasons behind these inequalities need further investigation in order to improve equality cancer outcomes in all social groups.
PB Dove Medical Press Ltd.
SN 1179-1349
YR 2020
FD 2020-07-25
LK http://hdl.handle.net/10668/16110
UL http://hdl.handle.net/10668/16110
LA en
NO Luque-Fernandez MA, Redondo-Sánchez D, Rodríguez-Barranco M, Chang-Chan YL, Salamanca-Fernández E, Núñez O, et al. Socioeconomic Inequalities in Colorectal Cancer Survival in Southern Spain: A Multilevel Population-Based Cohort Study. Clin Epidemiol. 2020 Jul 21;12:797-806.
DS RISalud
RD Apr 8, 2025