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

Détails

Ressource 1Télécharger: BIB_D9A23AF8C8BE.pdf (247.75 [Ko])
Etat: Public
Version: Final published version
ID Serval
serval:BIB_D9A23AF8C8BE
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Socioeconomic and demographic inequalities in stage at diagnosis and survival among colorectal cancer patients: evidence from a Swiss population-based study.
Périodique
Cancer medicine
Auteur⸱e⸱s
Feller A., Schmidlin K., Bordoni A., Bouchardy C., Bulliard J.L., Camey B., Konzelmann I., Maspoli M., Wanner M., Zwahlen M., Clough-Gorr K.M.
Collaborateur⸱rice⸱s
SNC and the NICER Working Group
Contributeur⸱rice⸱s
Egger M., Spoerri A., Puhan M., Bopp M., Künzli N., Bochud M., Oris M.
ISSN
2045-7634 (Electronic)
ISSN-L
2045-7634
Statut éditorial
Publié
Date de publication
04/2018
Peer-reviewed
Oui
Volume
7
Numéro
4
Pages
1498-1510
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
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.
Mots-clé
Adult, Aged, Aged, 80 and over, Colorectal Neoplasms/epidemiology, Colorectal Neoplasms/mortality, Colorectal Neoplasms/pathology, Female, Health Status Disparities, Humans, Male, Middle Aged, Neoplasm Staging, Odds Ratio, Population Surveillance, Registries, Risk Factors, Socioeconomic Factors, Survival Rate, Switzerland/epidemiology, Colorectal cancer, health inequalities, socioeconomic position, stage at diagnosis, survival
Pubmed
Web of science
Open Access
Oui
Création de la notice
08/03/2018 15:02
Dernière modification de la notice
21/11/2022 9:31
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