Cancer Patients’ Survival According to Socioeconomic Environment in a High-Income Country with Universal Health Coverage

SIMPLE SUMMARY: The main aim of our paper was to quantify the potential impact of socioeconomic environment on cancer patients’ survival in Slovenia in the 21st century. Despite of universal health coverage and after accounting for basic demographic variables (age and gender), differences in stage at diagnosis, as well as the impact of the cancer treatment improvements over time, we show that cancer patients in Slovenia who have a lower socioeconomic status experience worse survival and increased mortality. The results of this analysis could help decision-makers to better understand inequalities in cancer burden and inform the development of policies to improve or resolve them. ABSTRACT: Despite having an established systematic approach to population survival estimation in Slovenia, the influence of socioeconomic environment on cancer patients’ survival has not yet been evaluated. Thus, the main aim of our study was to quantify the potential impact of socioeconomic environment on cancer patients’ survival in our population in the 21st century. The net survival was calculated and stratified into quintiles of Slovenian version of the European Deprivation Index for all adult cancer patients diagnosed between 2004 and 2018 using the national cancer registry data. After accounting for basic demographic variables (age and gender), differences in stage at diagnosis, as well as the impact of the cancer treatment improvements over time, we found that cancer patients in Slovenia with lower socioeconomic status experience worse survival and have higher mortality. In particular, the odds of dying from oral, stomach, colorectal, liver, pancreatic, lung, breast, ovarian, corpus uteri, prostate, and bladder cancers, as well as for melanoma, leukemia, and non-Hodgkin lymphoma, are significantly higher in the socioeconomically most deprived group of patients compared to the most affluent group. The inequalities in cancer burden we found could help decision-makers to better understand the magnitude of this problem.