Abstract
Background:Differences in cancer survival exist across socio-economic groups for many cancer types. Standard metrics fail to show the overall impact for patients and the population.Methods:The available data consist of a population of ∼2.5 million patients and include all patients recorded as being diagnosed with melanoma, prostate, bladder, breast, colon, rectum, lung, ovarian and stomach cancers in England between 1998 and 2013. We estimated the average loss in expectation of life per patient in years and the proportion of life lost for a range of cancer types, separately by deprivation group. In addition, estimates for the total number of years lost due to each cancer were also obtained.Results:Lung and stomach cancers result in the highest overall loss for males and females in all deprivation groups in terms of both absolute life years lost and loss as a proportion of expected life remaining. Female lung cancer patients in the least- and most-deprived group lose 14.4 and 13.8 years on average, respectively, that is translated as 86.1% and 87.3% of their average expected life years remaining. Melanoma, prostate and breast cancers have the lowest overall loss. On the basis of the number of patients diagnosed in 2013, lung cancer results in the most life years lost in total followed by breast cancer. Melanoma and bladder cancer account for the lowest total life years lost.Conclusions:There are wide differences in the impact of cancer on life expectancy across deprivation groups, and for most cancers the most affluent lose less years.
Highlights
Differences in cancer survival exist across socio-economic groups for many cancer types
Approaches to estimate the impact of cancer for a patient tend to rely on metrics that are relevant at a particular point in followup time after diagnosis, such as 1- or 5-year relative survival (Andersson et al, 2013)
On average melanoma patients are diagnosed at the youngest age, whereas bladder cancer patients have the oldest age at diagnosis
Summary
The available data consist of a population of B2.5 million patients and include all patients recorded as being diagnosed with melanoma, prostate, bladder, breast, colon, rectum, lung, ovarian and stomach cancers in England between 1998 and 2013. We estimated the average loss in expectation of life per patient in years and the proportion of life lost for a range of cancer types, separately by deprivation group. Separate models were fitted for each cancer type and sex From these models we predicted the loss in expectation of life and the proportion of life lost for each of the five deprivation groups using the approach by Andersson et al, 2013. Expected mortality rates were obtained from population mortality files stratified by sex, age, deprivation group and calendar year (Spika et al)
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