New research from the Daffodil Centre, a partnership between Cancer Council NSW and the University of Sydney, has revealed that while cancer survival rates have improved significantly over the past four decades, people living in disadvantaged areas continue to face poorer outcomes. In fact, the team found that the differences between cancer survival for people in most and least disadvantaged areas have been widening over time.
The study, published in the Journal of the National Cancer Institute, analysed data from 942,241 people diagnosed with invasive solid cancers in NSW between 1980 and 2019. "We found that of people diagnosed with cancer in 1980-1989, almost 1 in 2 died from cancer within 5 years. But for those diagnosed with cancer in 2010-2019, that reduced to only about 1 in 4," says Associate Professor Julia Steinberg, Senior researcher on the study and Stream Lead of Genomics and Precision Health at the Daffodil Centre.
These survival increases are not shared by everyone. In a comprehensive analysis, the team found substantial differences in cancer survival by socioeconomic status, even when accounting for key factors such as cancer type and stage at diagnosis. In 20102019, people diagnosed with cancer who were living in the most disadvantaged areas across the state had a 35% higher rate of dying from cancer compared to those in the least disadvantaged areas. This gap has grown over time: back in 1980-1989, the difference was just 4%.
Associate Professor Steinberg says that in the 2000's, men in disadvantaged areas who were diagnosed with prostate cancer had a 29% higher rate of death than those in least disadvantaged areas, "But by the 2010s, that difference in death rates had increased to 58%, showing the gap has widened significantly."
Other cancers with widening disparities included breast, melanoma, colorectal, lung, bladder, and stomach cancers.
Across the entire study period and all solid cancers together, in the most disadvantaged areas, 37.2% of people diagnosed with cancer died from cancer within 5 years of their diagnosis, compared to 25.2% in the least disadvantaged areas.
Brad Gellert, Manager of Policy and Advocacy at Cancer Council NSW, says the findings highlight the urgent need for targeted action, "Whilst overall cancer survival rates are improving, this research makes it clear that some groups are being left behind." It is important to improve overall health outcomes for those in more disadvantaged areas, as they have a higher exposure to cancer risk factors like smoking, obesity and physical inactivity, are less likely to participate in screening programs, and are often diagnosed at later stages, leading to poorer outcomes. "They also face greater obstacles to care accessing care due to costs of treatment and travel, limited access to healthcare providers in rural locations, and cultural and language barriers," he says.
"This research underscores the need to invest now in initiatives that lift screening rates, reduce cancer risk, and remove barriers to accessing care for these communities." Mr Gellert concludes.
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