Feb. 27, 2014 — A new report, System Performance Special Focus Report: Examining Disparities in Cancer Control, released this month uncovers potentially important disparities in the cancer care received by Canadians based on how much they earn, where they live, and if they are recent immigrants or Canadian-born.
Led by the Canadian Partnership Against Cancer, the report shows that
people from the poorest urban neighbourhoods are less likely to survive
cancer compared with urban residents from the richest communities and
that this might be related to inequities in access to diagnosis and
treatment services.
The new report shows that the wealthiest
urban residents have a 73-per-cent chance of surviving their cancers
five years after a diagnosis (relative to others in the general
population of their age, sex and income level) compared with 61-per-cent
for people living in the poorest urban neighbourhoods.
"The
underlying cause for certain cancer disparities, including colorectal
cancer, in remote northern communities is multifactorial; however
inequities in social determinants and lifestyle risk factors would be
the driving force behind the significant differences," said Dr. Kami
Kandola, deputy chief public health officer, Government of Northwest
Territories.
"This new report can be helpful to jurisdictions
since it highlights existing disparities based on income, immigrant
status and geography. We now have a national benchmark to compare cancer
indicators through a health equity lens. This will allow appropriate
allocation of resources and prioritization of interventions to where the
need is greatest. Kudos to the Canadian Partnership Against Cancer for
bringing this to the forefront."
Earlier research has established
that, with higher rates of smoking and obesity, lower income and rural
Canadians have a greater risk of getting some cancers and dying from
them. However, gaps in survival tend to reflect differences in diagnosis
and treatment as opposed to differences in the risk of getting cancer.
In this context, the report reveals for the first time at a pan-Canadian
level that people living in lower income and rural and remote
communities may not be accessing the best cancer care as compared to
their wealthier urban neighbours.
For example, although finding cancers
early can often offer a better chance of surviving the disease, the
report's results suggest that Canadians from lower income households are
less likely to report being screened for cancer than those from
higher-income households. The screening rates for lowest versus highest
income Canadians are 61 per cent versus 77 per cent for breast, 25 per
cent versus 38 per cent for colorectal and 72 per cent versus 88 per
cent for cervical.
The report provides indicators suggesting that
across the diagnosis and treatment pathway from screening and early
detection, to radiation therapy, surgery, and enrolment in clinical
trials – at every step of the cancer-care journey, these lower income
and more rural-dwelling segments of the Canadian population could be
falling behind.
"The report's results confirm that inequities
exist in cancer outcomes and the cancer care received by Canadians.
Results also show where progress has been made through specific
interventions, such as improving access to breast screening in remote
communities through mobile mammography units," said Dr. Heather Bryant,
vice-president, cancer control at the Canadian Partnership Against
Cancer.
"Studies like this one are intended to identify best
practices that can be more broadly adopted to improve cancer control
across the country and to encourage conversations on how we could work
together more effectively to benefit all Canadians."
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