The influence of socioeconomic environment on cancer survival has been established in numerous studies in the European Union and the United States.
Prognosis was constantly poorer for the most underprivileged patients.
Dr Dejardin and colleagues from France investigated the influence of distance to care centre and deprivation on colon cancer survival.
|The association was maximal for patients with advanced cancer|
|Alimentary Pharmacology & Therapeutics|
The team used a multilevel Cox model, taking into account cancer stage at diagnosis and treatment modalities.
The team reported that the study population comprised 2066 cases of colon cancer.
The patients were diagnosed between 1997 and 2000 in 2 French areas covered by specialized cancer registries.
The researchers associated road distance to the nearest reference care center with poorer prognosis even after adjustment for stage at diagnosis.
The team analyzed subgroups, and showed that this association was maximal for patients with advanced cancer.
Access to chemotherapy in patients with advanced cancer varied according to distance explained the major part of geographic inequalities in survival.
Dr Dejardin's team concluded, "The major effect of distance from reference care center on survival suggests that current regional health planning does not guarantee equity in cancer management."
"Improvement in access to adjuvant therapy, especially for patients with advanced cancers, seems crucial for reducing geographic disparities in colon cancer survival."