The number of cancer-related deaths that could be attributable to spatial disparities in survival in Australia, 2010-2019: a retrospective population-based cohort study.

Abstract

To estimate the number of cancer-related deaths that could be attributed to spatial disparities in survival. Cohort study of cancer registry data. Australia, 1 January 2010 to 31 December 2019. The numbers and percentages of cancer-related deaths attributable to spatial disparities in survival were estimated by calculating the numbers of cancer-related deaths that would have occurred if all areas in Australia met or exceeded a benchmark 5-year survival rate. This benchmark corresponded to the survival rate of the area with survival better than 80% of all areas, with "area" referring to residential location at diagnosis. Of all 289 075 cancer-related deaths in Australia in 2010-2019, 33 892 (11.7%) were attributable to spatial disparities in survival. Although numbers were greatest in major cities, as remoteness and area disadvantage increased, the percentages of cancer-related deaths attributable to spatial disparities in survival increased. Of all cancer-related deaths in remote areas and the most socio-economically disadvantaged areas, 1569 of 5208 (30.1%) and 13 469 of 66 775 (20.2%) deaths were attributable to survival disparities, respectively. The highest numbers and percentages of attributable cancer deaths in remote areas were for rare cancers (529/1809 [29.3%]), lung cancer (300/1298 [23.1%]) and head and neck cancers (162/370 [43.8%]). In the most disadvantaged areas, rare cancers (3070/20 512 [15.0%]) and lung cancer (2640/18 057 [14.6%]) had the highest numbers of attributable cancer deaths. These findings quantify the impact of spatial disparities in survival and highlight the need for equitable access to diagnostic and treatment services across Australia.