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Annals of Oncology Advance Access published online on September 2, 2005

Annals of Oncology, doi:10.1093/annonc/mdj007
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© 2005 European Society for Medical Oncology
Received July 15, 2005
Accepted July 18, 2005

review

Origins of socio-economic inequalities in cancer survival: a review

L. M. Woods 1*, B. Rachet 1, and M. P. Coleman 1

1 Non-Communicable Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, London, UK

* To whom correspondence should be addressed.
L. M. Woods, E-mail: laura.woods{at}lshtm.ac.uk


   Abstract

Background: Cancer survival is known to vary by socio-economic group. A review of studies published by 1995 showed this association to be universal and resilient to the many different ways in which socio-economic status was determined. Differences were most commonly attributed to differences in stage of disease at diagnosis.

Materials and methods: A review of research published since 1995 examining the association of cancer survival with socio-economic variables.

Results: An association between socio-economic status and cancer survival has continued to be demonstrated in the last decade of research. Stage at diagnosis and differences in treatment have been cited as the most important explanatory factors. Some research has evaluated the psychosocial elements of this association.

Conclusions: Socio-economic differences in cancer survival are now well documented. The explanatory power of stage at diagnosis, although great, should not detract from the evidence of differential treatment between social groups. Neither factor can completely explain the observed socio-economic differences in survival, however, and the importance of differences in tumour and patient factors should now be quantified.

Keywords: cancer; deprivation; poverty; social class; socio-economic status; survival analysis.
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