Social inequalities in cancer survival

Social differentials in survival from twelve common types of cancer were assessed by estimating a 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 with similar persons without a cancer diagnosis was significantly related to education, occupation, and income. Excess mortality was, on the whole, about 15 per cent lower for men or women who had completed a post-secondary education than for those with only compulsory schooling, taking into account age, period and registered differences in tumour characteristics and stage at the time of diagnosis. The data do not provide clear indications of whether differences in host factors, such as co-morbidities and immune functions, or differences in treatment and care are primarily responsible for these inequalities in cancer survival.