Poorest bowel cancer patients more likely to die within month of surgery

June 14, 2012

(Medical Xpress) -- Bowel cancer patients living in the most deprived areas are 24 per cent more likely to die within five years of treatment than their more affluent neighbours and this difference appears to be a result of excess deaths within the first 30 days following surgery to treat the disease.

These are the findings of new data presented at the annual National Cancer Intelligence Network (NCIN) conference in Birmingham.1

Researchers at the West of Scotland Cancer Surveillance Unit working in collaboration with the West of Scotland Managed Clinical Network looked at nearly 4,300 patients who had for . The study compared patients of the same age at diagnosis and sex in the various .2

The results showed that for five-years after surgery for bowel cancer was lower among patients from the most - 59.5 per cent of patients analysed – compared with 69.7 per cent among the most affluent patients.

The researchers said that this was partly because more patients from deprived areas were diagnosed with bowel cancer through emergency presentations, with the disease at a later stage.3

Patients from more deprived areas were also more likely to have other illnesses and surgery was less likely to cure the disease compared to those from more affluent areas. These factors have lead to bowel cancer patients from deprived areas being more likely to die within 30 days of having surgery.

Raymond Oliphant, lead researcher and a clinical research fellow based at the University of Glasgow’s West of Scotland Cancer Surveillance Unit, said: “This research further highlights that survival following treatment for bowel cancer is better in people from the most affluent areas and worst among the most deprived.

“This study builds on previous research in this area by giving more detail on both short and longer term survival differences between patients from different economic backgrounds and will help those working on ways to improve outcomes for bowel cancer patients.”

When researchers excluded patients who died within the first 30-days of surgery from their analysis, they found no difference in survival between socioeconomic groups.
This suggests that the biggest impact on survival between deprived and affluent patients happens in the very first few weeks after surgery.

Chris Carrigan, head of the NCIN, said: “This study once again stresses the urgent need to improve the health of people living in deprived areas and to make sure all have an equal chance of surviving their cancer.

“Deprivation is one of the biggest causes of cancer inequality in this country. We know that people from more deprived areas are more likely to smoke or be very overweight. They are also less likely to be aware of signs and symptoms of cancer, probably leading to later diagnosis, which may further increase their chances of dying from their disease.

“We need to take a close look at factors like late , uptake of screening and variations in treatment for people from different social and economic backgrounds if we are to reduce inequality in cancer survival.

“But in the meantime everyone can do their bit by giving up smoking, which increases the risk of other diseases which affect the outcome of surgery, eating sensibly and seeing a GP as soon as possible if they notice anything unusual about their body.”

Explore further: Bowel cancer rates fall among rich men only

More information: 1. Oliphant, R et al,. The influence of socioeconomic circumstances on survival after surgery for colorectal cancer (2012)


2. Deprivation is calculated using the area-based Scottish Index of Multiple Deprivation – this calculates deprivation by generating a score for small population areas (containing 750 people based on postcode) derived from detailed information on seven key areas: 1) income and benefits 2) employment in working age population 3) health and healthcare utilisation 4) educational attainment, skills and training 5) access to services 6) recorded crime rates and 7) housing quality and overcrowding.  Overall area scores are then ranked from the least to most deprived and are presented in five equal groups.

3. Among the most deprived group of patients, 23.5 per cent were diagnosed with bowel cancer through emergency presentations compared with 19.5 per cent in the most affluent group.
There were fewer stage A (early stage) tumours in the most deprived group (12.5 per cent) compared to the most affluent group (17.9 per cent).
73.3 per cent of the most deprived group were treated by major surgery compared with 82.6 per cent in the most affluent group of patients.
9.6 per cent of the most deprived patients died within 30 days of having surgery to treat bowel cancer compared with 4.2 per cent in the most affluent group.
The study looked at patients diagnosed with bowel cancer in the West of Scotland from January 2001 to December 2004 identified from the Scottish Cancer Registry linked to clinical audit data from the West of Scotland Colorectal Cancer Managed Clinical Network .

Related Stories

Bowel cancer rates fall among rich men only

June 1, 2011
(Medical Xpress) -- Men living in deprived areas now suffer from higher levels of bowel cancer than those from more affluent areas Glasgow academics have found.

Poor men more likely to die from bowel cancer

November 7, 2011
(Medical Xpress) -- Deprived men are more likely to die from bowel cancer than men from the most affluent section of society, new research presented at the NCRI Cancer Conference in Liverpool this week shows.

Nearly 10 per cent of bowel cancer patients die within a month of diagnosis

March 27, 2012
(Medical Xpress) -- Almost 10 per cent of bowel cancer patients die within a month of being diagnosed according to new analysis by the National Cancer Intelligence Network (NCIN), published today.

Latest cancer research unveiled

June 20, 2011
Two leading experts from the Division of Cancer Studies at King’s presented their latest research into cancer survival this week at the National Cancer Intelligence Network conference in London.

Poor people more likely to view cancer as fatal

October 10, 2011
(Medical Xpress) -- People in lower paid jobs are pessimistic about the benefits of diagnosing cancer early and more scared than affluent people to see a doctor about an unusual symptom, new research shows.

Recommended for you

Soy, cruciferous vegetables associated with fewer common breast cancer treatment side effects

December 11, 2017
Consuming soy foods (such as soy milk, tofu and edamame) and cruciferous vegetables (such as cabbages, kale, collard greens, bok choy, Brussels sprouts, and broccoli) may be associated with a reduction in common side effects ...

CAR T, immunotherapy bring new hope for multiple myeloma patients

December 11, 2017
Two investigational immunotherapy approaches, including chimeric antigen receptor (CAR) T cell therapy, have shown encouraging results in the treatment of multiple myeloma patients who had relapsed and were resistant to other ...

Tracking how multiple myeloma evolves by sequencing DNA in the blood

December 10, 2017
Although people with multiple myeloma usually respond well to treatment, the blood cancer generally keeps coming back. Following genetic changes in how the disease evolves over time will help to understand the disease and, ...

Landmark CAR-T cancer study published

December 10, 2017
Loyola University Medical Center is the only Chicago center that participated in the pivotal clinical trial of a groundbreaking cancer treatment that genetically engineers a patient's immune system to attack cancer cells.

Study finds emojis promising tool for tracking cancer patients' quality of life

December 10, 2017
In findings presented to the American Society of Hematology, Mayo Clinic researchers found that using emojis instead of traditional emotional scales were helpful in assessing patients' physical, emotional and overall quality ...

Study explores use of checkpoint inhibitors after relapse from donor stem cell transplant

December 10, 2017
Immunotherapy agents known as checkpoint inhibitors have shown considerable promise in patients with hematologic cancers who relapse after a transplant with donor stem cells. Preliminary results from the first clinical trial ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.