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Socioeconomic and demographic inequalities in stage at diagnosis and survival among colorectal cancer patients: evidence from a Swiss population‐based study

Socioeconomic inequalities in cancer stage at diagnosis and survival are important public health issues. This study investigates the association between socioeconomic position (SEP) and colorectal cancer (CRC) stage at diagnosis and survival in Switzerland, a European country with highest level of m...

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Autores principales: Feller, Anita, Schmidlin, Kurt, Bordoni, Andrea, Bouchardy, Christine, Bulliard, Jean‐Luc, Camey, Bertrand, Konzelmann, Isabelle, Maspoli, Manuela, Wanner, Miriam, Zwahlen, Marcel, Clough‐Gorr, Kerri M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5911574/
https://www.ncbi.nlm.nih.gov/pubmed/29479854
http://dx.doi.org/10.1002/cam4.1385
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author Feller, Anita
Schmidlin, Kurt
Bordoni, Andrea
Bouchardy, Christine
Bulliard, Jean‐Luc
Camey, Bertrand
Konzelmann, Isabelle
Maspoli, Manuela
Wanner, Miriam
Zwahlen, Marcel
Clough‐Gorr, Kerri M.
author_facet Feller, Anita
Schmidlin, Kurt
Bordoni, Andrea
Bouchardy, Christine
Bulliard, Jean‐Luc
Camey, Bertrand
Konzelmann, Isabelle
Maspoli, Manuela
Wanner, Miriam
Zwahlen, Marcel
Clough‐Gorr, Kerri M.
author_sort Feller, Anita
collection PubMed
description Socioeconomic inequalities in cancer stage at diagnosis and survival are important public health issues. This study investigates the association between socioeconomic position (SEP) and colorectal cancer (CRC) stage at diagnosis and survival in Switzerland, a European country with highest level of medical facilities and life expectancy. We used population‐based CRC data from seven Swiss cantonal cancer registries 2001–2008 (N = 10,088) linked to the Swiss National Cohort (SNC). Follow‐up information was available until the end of 2013. SEP was estimated based on education. The association between cancer stage and SEP was assessed using logistic regression models including cancer localization (colon/rectum), sex, age, civil status, urbanity of residence, language region, and nationality (Swiss/non‐Swiss). Survival was analyzed using competing risk regressions reporting subhazard ratios (SHRs) for the risk of dying due to CRC. We observed a social gradient for later stage CRC with adjusted odds ratios (ORs) of 1.11 (95% CI: 0.97–1.19) and 1.28 (95% CI: 1.08–1.50) for middle and low SEP compared to high SEP. Further, single compared to married people had elevated odds of being diagnosed at later stages. Survival was lower in patients with CRC with low SEP in the unadjusted model (SHR: 1.18, 95% CI: 1.07–1.30). After adjustment for stage at diagnosis and further sociodemographic characteristics, significant survival inequalities by SEP disappeared but remained for non‐Swiss compared to Swiss citizens and for patients living in nonurban areas compared to their urban counterparts. Swiss public health strategies should facilitate equal access to CRC screening and optimal CRC care for all social groups and in all regions of Switzerland.
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spelling pubmed-59115742018-04-30 Socioeconomic and demographic inequalities in stage at diagnosis and survival among colorectal cancer patients: evidence from a Swiss population‐based study Feller, Anita Schmidlin, Kurt Bordoni, Andrea Bouchardy, Christine Bulliard, Jean‐Luc Camey, Bertrand Konzelmann, Isabelle Maspoli, Manuela Wanner, Miriam Zwahlen, Marcel Clough‐Gorr, Kerri M. Cancer Med Cancer Prevention Socioeconomic inequalities in cancer stage at diagnosis and survival are important public health issues. This study investigates the association between socioeconomic position (SEP) and colorectal cancer (CRC) stage at diagnosis and survival in Switzerland, a European country with highest level of medical facilities and life expectancy. We used population‐based CRC data from seven Swiss cantonal cancer registries 2001–2008 (N = 10,088) linked to the Swiss National Cohort (SNC). Follow‐up information was available until the end of 2013. SEP was estimated based on education. The association between cancer stage and SEP was assessed using logistic regression models including cancer localization (colon/rectum), sex, age, civil status, urbanity of residence, language region, and nationality (Swiss/non‐Swiss). Survival was analyzed using competing risk regressions reporting subhazard ratios (SHRs) for the risk of dying due to CRC. We observed a social gradient for later stage CRC with adjusted odds ratios (ORs) of 1.11 (95% CI: 0.97–1.19) and 1.28 (95% CI: 1.08–1.50) for middle and low SEP compared to high SEP. Further, single compared to married people had elevated odds of being diagnosed at later stages. Survival was lower in patients with CRC with low SEP in the unadjusted model (SHR: 1.18, 95% CI: 1.07–1.30). After adjustment for stage at diagnosis and further sociodemographic characteristics, significant survival inequalities by SEP disappeared but remained for non‐Swiss compared to Swiss citizens and for patients living in nonurban areas compared to their urban counterparts. Swiss public health strategies should facilitate equal access to CRC screening and optimal CRC care for all social groups and in all regions of Switzerland. John Wiley and Sons Inc. 2018-02-26 /pmc/articles/PMC5911574/ /pubmed/29479854 http://dx.doi.org/10.1002/cam4.1385 Text en © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Cancer Prevention
Feller, Anita
Schmidlin, Kurt
Bordoni, Andrea
Bouchardy, Christine
Bulliard, Jean‐Luc
Camey, Bertrand
Konzelmann, Isabelle
Maspoli, Manuela
Wanner, Miriam
Zwahlen, Marcel
Clough‐Gorr, Kerri M.
Socioeconomic and demographic inequalities in stage at diagnosis and survival among colorectal cancer patients: evidence from a Swiss population‐based study
title Socioeconomic and demographic inequalities in stage at diagnosis and survival among colorectal cancer patients: evidence from a Swiss population‐based study
title_full Socioeconomic and demographic inequalities in stage at diagnosis and survival among colorectal cancer patients: evidence from a Swiss population‐based study
title_fullStr Socioeconomic and demographic inequalities in stage at diagnosis and survival among colorectal cancer patients: evidence from a Swiss population‐based study
title_full_unstemmed Socioeconomic and demographic inequalities in stage at diagnosis and survival among colorectal cancer patients: evidence from a Swiss population‐based study
title_short Socioeconomic and demographic inequalities in stage at diagnosis and survival among colorectal cancer patients: evidence from a Swiss population‐based study
title_sort socioeconomic and demographic inequalities in stage at diagnosis and survival among colorectal cancer patients: evidence from a swiss population‐based study
topic Cancer Prevention
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5911574/
https://www.ncbi.nlm.nih.gov/pubmed/29479854
http://dx.doi.org/10.1002/cam4.1385
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