A team from the University of Glasgow, Scotland, investigated the impact of socioeconomic deprivation on outcome after surgery for colorectal cancer.
A total of 2269 patients undergoing resection for colorectal cancer in hospitals in central Scotland, between 1991 and 1994, were studied.
Socioeconomic status was defined using the Carstairs deprivation index.
The impact of deprivation on case mix, treatment, and outcome was analyzed.
There were no significant differences in mode of presentation, extent of disease at presentation, type of resection, and postoperative mortality rate among the socioeconomic groups.
Following curative resection, the overall survival rate at 5 years was 47% in deprived patients, compared with 55% in affluent patients.
|Cancer-specific survival rates at 5 years:|
|British Journal of Surgery |
The cancer-specific survival rate was 63% in the deprived and 68% in the affluent.
Compared with the affluent, the adjusted hazard ratios for the deprived were 1·36 for overall mortality and 1·26 for cancer-specific mortality.
The researchers found that, following palliative resection, there was no difference in survival between the affluent and deprived for either overall or cancer-specific mortality.
Professor D. J. Hole, of the Department of Public Health at the University of Glasgow, concluded, "These findings confirm that the cancer-specific survival rate following surgery for colorectal cancer is lower in deprived patients.
"Stage of disease at presentation and type of operation did not account for this difference.
"The excess mortality was confined to patients undergoing apparently curative resection."