Social inequalities in cancer survival

Social differentials in the survival from 12 common types of cancer were assessed by estimating a recently developed mixed additive-multiplicative hazard model on the basis of individual register and census data for the whole Norwegian population. The excess all-cause mortality among cancer patients compared to otherwise equal persons without a cancer diagnosis was significantly related both to education, occupation and income. It was, on the whole, about 15% lower for men or women who had completed a post-secondary education than for those with only compulsory schooling, taking age, period and registered differences in tumor characteristics and stage at the time of diagnosis into account. The data do not provide clear indications of whether differences in host factors, such as co-morbities and immune functions, or differences in treatment and care are primarily responsible for these inequalities in cancer survival.