No socioeconomic inequalities in colorectal cancer survival within a randomised clinical trial
Author Information
Author(s): Nur U, Rachet B, Parmar M K B, Sydes M R, Cooper N, Lepage C, Northover J M A, James R, Coleman M P
Primary Institution: Cancer Research UK Cancer Survival Group, London School of Hygiene and Tropical Medicine
Hypothesis
If the socioeconomic gradient in survival was abolished in the setting of a trial, with equal treatment for all patients, then differences in treatment would become a more plausible explanation for the socioeconomic differences in survival as seen in the general population.
Conclusion
Given equal treatment, colorectal cancer survival in England and Wales does not appear to depend on socioeconomic status.
Supporting Evidence
- Relative survival in trial patients was higher than in the general population of England and Wales.
- The socioeconomic gradient in survival was much smaller than that seen for colorectal cancer patients in the general population.
- The study analyzed data from 2481 patients diagnosed during 1989–1997.
Takeaway
This study found that when colorectal cancer patients receive the same treatment, their chances of surviving do not depend on how rich or poor they are.
Methodology
Data from 2481 patients in a randomised controlled trial were analyzed to estimate survival across socioeconomic categories using multivariable models.
Potential Biases
The socioeconomic distribution of patients was unknown at randomisation, which could introduce bias.
Limitations
Statistical power was limited due to the relatively small number of deaths in each deprivation group.
Participant Demographics
Over 90% of patients were aged 40–79 years, and 60.7% were male.
Statistical Information
Confidence Interval
95% CI −7.3 to 1.0% for 1 year, 95% CI −8.3 to 4.9% for 5 years
Digital Object Identifier (DOI)
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