DEPRIVATION, STAGE AT DIAGNOSIS AND CANCER SURVIVAL

The association between an area-based measure of deprivation and survi val from the 10 most common cancers was studied in 155,682 patients di agnosed between 1980 and 1989 in the area covered by the South Thames Regional Health Authority. Furthermore, the impact of stage of disease at diagnosis on this association was studied. The measure of deprivat ion was the Carstairs Index of the census enumeration district of each patient's residence at diagnosis (5 categories) and the cancers studi ed were: lung, breast, colorectum, bladder, prostate, stomach, pancrea s, ovary, uterus and cervix. In the univariate analyses the measure of outcome was the relative survival rate and in the multivariate analys es it was the hazard ratio. Both univariate and multivariate analyses showed that patients from affluent areas had better survival than pati ents from deprived areas for cancers of the lung, breast, colorectum, bladder, prostate, uterus and cervix. Stage of disease at diagnosis di d not explain the survival differences by deprivation category. For ca ncers of the stomach, pancreas and ovary, no variation in survival by deprivation category was found. For most cancer sites, a clear gradien t in survival by deprivation category was observed, which implies a la rge potential reduction of cancer mortality among the lower socioecono mic groups. Future studies need to incorporate other possible explanat ory factors, besides stage, of the association between deprivation and survival. (C) 1995 Wiley-Liss, Inc.