Cancer survival in New Zealand: Ethnic, social and geographical inequalities

被引:94
作者
Haynes, Robin [1 ]
Pearce, Jamie [2 ]
Barnett, Ross [2 ]
机构
[1] Univ E Anglia, Sch Environm Sci, Norwich NR4 7TJ, Norfolk, England
[2] Univ Canterbury, Dept Geog, Christchurch 1, New Zealand
关键词
New Zealand; cancer survival; health inequalities; ethnic differences; deprivation; travel to hospital;
D O I
10.1016/j.socscimed.2008.05.005
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
This study investigated the combined effects of ethnicity. deprivation and geographical access to health services on the likelihood of survival from a range of common cancers in New Zealand. Individual cancer registry records of 99,062 cases of melanoma, colorectal, lung, breast and prostate cancers diagnosed in the period 1994-2004 were supplemented with small area information on social deprivation and estimates of travel time to the nearest primary care and cancer centre. Logistic regression was used to identify the variables associated with advanced extent of the disease at diagnosis. Adverse influences on survival were investigated using Cox proportional hazards models. Controlling for age and gender, Maori and Pacific peoples' ethnicity was strongly associated with poorer survival, partly because ethnicity was also linked to the likelihood of advanced disease at diagnosis. Living in a deprived area was related to later stage presentation and poorer survival of people with melanoma. but there was no other evidence that living in a deprived area or in a remote location were associated with later stage presentation. Some disease-specific trends in survival were observed. Colorectal and lung cancers were more likely to be fatal for people living in deprived areas, survival from prostate cancer was poor for men living remote from primary care, and people with colorectal, breast and prostate cancers had adverse survival chances if they lived distant from a cancer centre. (C) 2008 Elsevier Ltd. All rights reserved.
引用
收藏
页码:928 / 937
页数:10
相关论文
共 97 条
[1]  
[Anonymous], 2003, NZ CANC CONTR STRAT
[2]  
[Anonymous], 2002, NZDEP2001 INDEX DEPR
[3]  
[Anonymous], 2004, SOC POLICY J NZ
[4]  
[Anonymous], 2004, NEW ZEAL MED J
[5]   SOCIAL-CLASS AND CANCER-PATIENT SURVIVAL IN FINLAND [J].
AUVINEN, A ;
KARJALAINEN, S ;
PUKKALA, E .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 1995, 142 (10) :1089-1102
[6]   Racial differences in the treatment of early-stage lung cancer [J].
Bach, PB ;
Cramer, LD ;
Warren, JL ;
Begg, CB .
NEW ENGLAND JOURNAL OF MEDICINE, 1999, 341 (16) :1198-1205
[7]   Cohort study in South and West England of the influence of specialization on the management and outcome of patients with oesophageal and gastric cancers [J].
Bachmann, MO ;
Alderson, D ;
Edwards, D ;
Wotton, S ;
Bedford, C ;
Peters, TJ ;
Harvey, IM .
BRITISH JOURNAL OF SURGERY, 2002, 89 (07) :914-922
[8]   Cervical screening and health inequality in England in the 1990s [J].
Baker, D ;
Middleton, E .
JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 2003, 57 (06) :417-423
[9]   The importance of place of residence in predicting late-stage diagnosis of breast or cervical cancer [J].
Barry, J ;
Breen, N .
HEALTH & PLACE, 2005, 11 (01) :15-29
[10]  
Birch Stephen, 2007, Aust New Zealand Health Policy, V4, P12, DOI 10.1186/1743-8462-4-12