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Social inequality in head and neck squamous cell carcinoma survival - the influence of clinical prognostic factors, comorbidity, life style and the introduction of the National Integrated Cancer Pathways
In a previous population-based study we have observed a significant socioeconomic inequality in survival after cancer in Denmark, particularly in Head and Neck Squamous Cell Carcinoma (HNSCC). The aim of this project is to study the association between socioeconomic position and various prognostic factors and the extent to which these factors explain the socieconomic gradient in survival after HNSCC.
In the Danish Head and Neck Cancer Group (DAHANCA) database we will identify all patients diagnosed with HNSCC between 1992 and 2013. By linkage of individual data from nationwide administrative registries we have a unique opportunity to study the association between various socioeconomic and prognostic factors, including stage at diagnosis, tumour-localisation, comorbidity, HPV-status, tobacco-use, systematic care and follow-up.
A considerable part of the excess burden of HNSCC deaths among deprived patients may be preventable. By identifying where in the trajectory of cancer the socieconomic inequality arises, we will provide knowledge about where targeted interventions may be efficiently implemented.
Behind the research
Contact:
PhD student Maja Halgren Olsen
e-mail: majols@cancer.dk
Collaborations:
Professor Jens Overgaard, Aarhus University Hospital
Changes in social inequality in cancer survival over time in Denmark
In a large collaborative study published in 2008 researchers from the Danish Cancer Society illustrated a clear social inequality in cancer survival in Denmark despite a tax-financed health system with free and equal access to cancer treatment.
These results led us to initiate a number of studies investigating whether stage at diagnosis, access to treatment, and comorbidity mediated the differences in survival between social groups in Denmark in close collaboration with several of the National Clinical Cancer Databases.
In this study we aim to provide an overview of relative and absolute differences in 1- and 5-year relative survival for cancer patients diagnosed from 2005-9 and compare this to 5-year relative survival for cancer patients diagnosed form 1987-1991 in order to describe temporal differences in social inequality.
Behind the research
Contact:
Senior Researcher Susanne Oksbjerg Dalton
e-mail: sanne@cancer.dk
Collaborations:
Klaus Kaae Andersen, Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center
Effect of socioeconomic position on survival after childhood cancer in Denmark
Treatment protocols for childhood cancer are generally standardized in Denmark as in most other Western countries. Free public health care makes access to treatment equal across social groups and although never formerly studied, equal survival rates have been assumed to be the result. In other developed countries with similar level of welfare a difference in survival by parents' social group indicate that social inequality might exist in survival after childhood cancer.
In this study, we investigate as the first in Denmark how parental educational level, income, cohabitation, and the child's number of siblings effect the survival after childhood cancer in Denmark.
Via the Cancer Registry we identify all children aged 0-19 years diagnosed with cancer in 1990-2009. For all cancer patients vital status will be identified, and by linkage of the cohort to the CANULI database at Statistics Denmark, parents and siblings will be identified, and information on educational level, income, and cohabitation for the parents will be obtained.
Behind the research
Contact:
Senior Researcher Susanne Oksbjerg Dalton
e-mail: sanne@cancer.dk
Collaborations:
This study is conducted by medical student Sofie Simony.
External collaborators include Professor Kjeld Schmiegelow, Rigshospitalet; Section Head Joachim Schüz and Postdoc Friederike Erdman, IARC