Journal
HEALTH & PLACE
Volume 18, Issue 6, Pages 1412-1421Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.healthplace.2012.07.006
Keywords
Cancer; Premature deaths; Relative survival; Spatial; Bayesian
Categories
Funding
- National Health and Medical Research Council (NHMRC) Career Development Fellowship [ID 1005334]
- CRC
- NHMRC Senior Research Fellowship [ID 1003710]
- NHMRC [ID 561700]
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This study examines the influence of cancer stage, distance to treatment facilities and area disadvantage on breast and colorectal cancer spatial survival inequalities. We also estimate the number of premature deaths after adjusting for cancer stage to quantify the impact of spatial survival inequalities. Population-based descriptive study of residents aged < 90 years in Queensland, Australia diagnosed with primary invasive breast (25,202 females) or colorectal (14,690 males, 11,700 females) cancers during 1996-2007. Bayesian hierarchical models explored relative survival inequalities across 478 regions. Cancer stage and disadvantage explained the spatial inequalities in breast cancer survival, however spatial inequalities in colorectal cancer survival persisted after adjustment. Of the 6,019 colorectal cancer deaths within 5 years of diagnosis, 470 (8%) were associated with spatial inequalities in non-diagnostic factors, i.e. factors beyond cancer stage at diagnosis. For breast cancers, of 2,412 deaths, 170 (7%) were related to spatial inequalities in non-diagnostic factors. Quantifying premature deaths can increase incentive for action to reduce these spatial inequalities. (C) 2012 Elsevier Ltd. All rights reserved.
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