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Socioeconomic status and diagnosis, treatment, and mortality in men with prostate cancer. Nationwide population‐based study

Patients with high socioeconomic status (SES) have better cancer outcomes than patients with low SES. This has also been shown in Sweden, a country with tax‐financed health care aiming to provide care on equal terms to all residents. The association between income and educational level and diagnosti...

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Autores principales: Tomic, Katarina, Ventimiglia, Eugenio, Robinson, David, Häggström, Christel, Lambe, Mats, Stattin, Pär
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/PMC5947133/
https://www.ncbi.nlm.nih.gov/pubmed/29363113
http://dx.doi.org/10.1002/ijc.31272
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author Tomic, Katarina
Ventimiglia, Eugenio
Robinson, David
Häggström, Christel
Lambe, Mats
Stattin, Pär
author_facet Tomic, Katarina
Ventimiglia, Eugenio
Robinson, David
Häggström, Christel
Lambe, Mats
Stattin, Pär
author_sort Tomic, Katarina
collection PubMed
description Patients with high socioeconomic status (SES) have better cancer outcomes than patients with low SES. This has also been shown in Sweden, a country with tax‐financed health care aiming to provide care on equal terms to all residents. The association between income and educational level and diagnostics and treatment as outlined in national guidelines and prostate cancer (Pca) and all‐cause mortality was assessed in 74,643 men by use of data in the National Prostate Cancer Register of Sweden and a number of other health care registers and demographic databases. In multivariable logistic regression analysis, men with high income had higher probability of Pca detected in a health‐check‐up, top versus bottom income quartile, odds ratio (OR) 1.60 (95% CI 1.45–1.77) and lower probability of waiting more than 3 months for prostatectomy, OR 0.77 (0.69–0.86). Men with the highest incomes also had higher probability of curative treatment for intermediate and high‐risk cancer, OR 1.77 (1.61–1.95) and lower risk of positive margins, (incomplete resection) at prostatectomy, OR 0.80 (0.71–0.90). Similar, but weaker associations were observed for educational level. At 6 years of follow‐up, Pca mortality was modestly lower for men with high income, which was statistically significant for localized high‐risk and metastatic Pca in men with no comorbidities. All‐cause mortality was less than half in top versus bottom quartile of income (12% vs. 30%, p < 0.001) among men above age 65. Our findings underscore the importance of adherence to guidelines to ensure optimal and equal care for all patients diagnosed with cancer.
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spelling pubmed-59471332018-05-17 Socioeconomic status and diagnosis, treatment, and mortality in men with prostate cancer. Nationwide population‐based study Tomic, Katarina Ventimiglia, Eugenio Robinson, David Häggström, Christel Lambe, Mats Stattin, Pär Int J Cancer Cancer Epidemiology Patients with high socioeconomic status (SES) have better cancer outcomes than patients with low SES. This has also been shown in Sweden, a country with tax‐financed health care aiming to provide care on equal terms to all residents. The association between income and educational level and diagnostics and treatment as outlined in national guidelines and prostate cancer (Pca) and all‐cause mortality was assessed in 74,643 men by use of data in the National Prostate Cancer Register of Sweden and a number of other health care registers and demographic databases. In multivariable logistic regression analysis, men with high income had higher probability of Pca detected in a health‐check‐up, top versus bottom income quartile, odds ratio (OR) 1.60 (95% CI 1.45–1.77) and lower probability of waiting more than 3 months for prostatectomy, OR 0.77 (0.69–0.86). Men with the highest incomes also had higher probability of curative treatment for intermediate and high‐risk cancer, OR 1.77 (1.61–1.95) and lower risk of positive margins, (incomplete resection) at prostatectomy, OR 0.80 (0.71–0.90). Similar, but weaker associations were observed for educational level. At 6 years of follow‐up, Pca mortality was modestly lower for men with high income, which was statistically significant for localized high‐risk and metastatic Pca in men with no comorbidities. All‐cause mortality was less than half in top versus bottom quartile of income (12% vs. 30%, p < 0.001) among men above age 65. Our findings underscore the importance of adherence to guidelines to ensure optimal and equal care for all patients diagnosed with cancer. John Wiley and Sons Inc. 2018-02-02 2018-06-15 /pmc/articles/PMC5947133/ /pubmed/29363113 http://dx.doi.org/10.1002/ijc.31272 Text en © 2018 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Cancer Epidemiology
Tomic, Katarina
Ventimiglia, Eugenio
Robinson, David
Häggström, Christel
Lambe, Mats
Stattin, Pär
Socioeconomic status and diagnosis, treatment, and mortality in men with prostate cancer. Nationwide population‐based study
title Socioeconomic status and diagnosis, treatment, and mortality in men with prostate cancer. Nationwide population‐based study
title_full Socioeconomic status and diagnosis, treatment, and mortality in men with prostate cancer. Nationwide population‐based study
title_fullStr Socioeconomic status and diagnosis, treatment, and mortality in men with prostate cancer. Nationwide population‐based study
title_full_unstemmed Socioeconomic status and diagnosis, treatment, and mortality in men with prostate cancer. Nationwide population‐based study
title_short Socioeconomic status and diagnosis, treatment, and mortality in men with prostate cancer. Nationwide population‐based study
title_sort socioeconomic status and diagnosis, treatment, and mortality in men with prostate cancer. nationwide population‐based study
topic Cancer Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5947133/
https://www.ncbi.nlm.nih.gov/pubmed/29363113
http://dx.doi.org/10.1002/ijc.31272
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