Disparities in cancer survival by socioeconomic status: findings from a population-based study of 942,241 Australians from 1980 to 2019.

Abstract

Cancer survival in Australia has improved over time, but disparities by socioeconomic status (SES) persist. We analyzed data from the population-wide New South Wales Cancer Registry, including 942,241 individuals with invasive solid cancers diagnosed 1980-2019. We examined cancer-specific and all-cause deaths by area-based SES for all solid cancers and 12 common cancers, using competing risks regression alongside crude survival. Five-year cancer-specific survival for all cancers improved from 50.3% in 1980-89 to 73.3% in 2010-19. Risk of cancer death was higher for individuals living in most socio-economically disadvantaged areas (versus least disadvantaged areas), and differences increased over time: from sub-hazard ratio 1.04 (95%CI : 1.02-1.07) in 1980-89, to 1.35 (95%CI : 1.32-1.38) in 2010-19 (adjusting for age, sex, cancer type, cancer spread). Statistically significant and increasing differences were observed for prostate, breast, melanoma, colorectal, lung, bladder and stomach cancers. Disparities in cancer survival have continued to widen, requiring improved understanding and targeted interventions to address inequities.