Socioeconomic disparities in childhood cancer survival in Switzerland.

Adam, Martin; Rueegg, Corina S; Schmidlin, Kurt; Spoerri, Adrian; Niggli, Felix; Grotzer, Michael; von der Weid, Nicolas X; Egger, Matthias; Probst-Hensch, Nicole; Zwahlen, Marcel; Kuehni, Claudia (2016). Socioeconomic disparities in childhood cancer survival in Switzerland. International journal of cancer, 138(12), pp. 2856-2866. Wiley-Blackwell 10.1002/ijc.30029

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In this study, we investigated whether childhood cancer survival in Switzerland is influenced by socioeconomic status (SES), and if disparities vary by type of cancer and definition of SES (parental education, living condition, area-based SES). Using Cox proportional hazards models, we analyzed 5-year cumulative mortality in all patients registered in the Swiss Childhood Cancer Registry diagnosed 1991-2006 below 16 years. Information on SES was extracted from the Swiss census by probabilistic record linkage. The study included 1602 children (33% with leukemia, 20% with lymphoma, 22% with central nervous system (CNS) tumors); with an overall 5-year survival of 77% (95%CI 75-79%). Higher SES, particularly parents' education, was associated with a lower 5-year cumulative mortality. Results varied by type of cancer with no association for leukemia and particularly strong effects for CNS tumor patients, where mortality hazard ratios for the different SES indicators, comparing the highest with the lowest group, ranged from 0.48 (95%CI: 0.28-0.81) to 0.71 (95%CI: 0.44-1.15). We conclude that even in Switzerland with a high quality health care system and mandatory health insurance, socioeconomic differences in childhood cancer survival persist. Factors causing these survival differences have to be further explored, to facilitate universal access to optimal treatment and finally eliminate social inequalities in childhood cancer survival. This article is protected by copyright. All rights reserved.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Rüegg, Corina Silvia; Schmidlin, Kurt; Spörri, Adrian; Egger, Matthias; Zwahlen, Marcel and Kühni, Claudia

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0020-7136

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

15 Mar 2016 14:32

Last Modified:

10 Sep 2017 02:00

Publisher DOI:

10.1002/ijc.30029

PubMed ID:

26840758

Uncontrolled Keywords:

5-year survival; central nervous system tumor; childhood cancer; leukemia; mortality; socioeconomic status

BORIS DOI:

10.7892/boris.79911

URI:

https://boris.unibe.ch/id/eprint/79911

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