[Social inequalities in cancer survival]

Social differentials in survival from 12 common types of cancer are assessed by estimating an 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 with similar persons without a cancer diagnosis is significantly related to education, occupation and income. It is, on the whole, about 15% lower for men or women with a completed post-secondary education than for those with only compulsory schooling, with age, period, histology and stage at the time of diagnosis taken into account. The prognosis is even better for those with an education at Master level, who can expect to live more than one year longer after the diagnosis than those with only compulsory education, as a rough average over the cancer sites. The data do not provide clear indications of whether differences in host factors, such as comorbidities, immune functions and lifestyle, or differences in treatment are primarily responsible for these inequalities in survival.