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Friday, 21 February 2014

Disparities in Cancer Control – or the determinants of cancer survival

Hot off the press is a well written exploration of disparities in outcome related to cancer management in Canada.  Produced by the Canadian Partnership Against Cancer who have effectively advocated and received funding to improve cancer outcomes nationally, and includes most of the provincial cancer control agencies augmented by the Canadian Cancer Society (although the actual partners are not listed on their Website home) .  The maintain a wealth of excellent information and surfing their site is worth a few minutes.

Perhaps it is notable that the disparities report is not yet locatable on the Partnership website, but can be accessed at Disparities in Cancer Control.   The 75 page report delves into the inequities carried by lower income, rural and remote residents, new immigrants, and carefully skirts First nations issues. 

The reading is not for the average Canadian, with a degree in epidemiology an asset.  However most public health professionals will be able to appreciate the tabulations against the three identified groups by; cancer risk factors, access to cancer screening, from screening to resolution for breast cancer, incidence and mortality from stage comparable cancers,  time of treatment, type of treatment (eg mastectomy versus breast conserving surgery), clinical trial participation, and finally a specific section on survival. 

While the majority of findings are not surprising in that those in lower income groups, those living in rural and remote areas, and those geographic areas with higher proportions of immigrants tend to be associated with measures that are relatively poorer, there are some surprises.  Notably are some of the relationships between risk factors which in this study puts smoking and alcohol consumption, and obesity rates higher in higher income groups, and generally lower in immigrant populations. 

While not yet a full exploration of the impacts of determinants of health on cancer, it is a step in the right direction, and well worth keeping a copy for reference.  

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