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Poorest bowel cancer patients more likely to die within month of surgery

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Bowel cancer patients living in the most deprived areas are 24 per cent more likely to die within five years of treatment than their more affluent neighbours and this difference appears to be a result of excess deaths within the first 30 days following surgery to treat the disease.

These are the findings of new data presented at the annual National Cancer Intelligence Network (NCIN) conference in Birmingham.1

Researchers at the West of Scotland Cancer Surveillance Unit working in collaboration with the West of Scotland Colorectal Cancer Managed Clinical Network looked at nearly 4,300 patients who had surgery for bowel cancer. The study compared patients of the same age at diagnosis and sex in the various socioeconomic groups.2

The results showed that survival for five-years after surgery for bowel cancer was lower among patients from the most deprived areas – 59.5 per cent of patients analysed – compared with 69.7 per cent among the most affluent patients.

The researchers said that this was partly because more patients from deprived areas were diagnosed with bowel cancer through emergency presentations, with the disease at a later stage.3

Patients from more deprived areas were also more likely to have other illnesses and surgery was less likely to cure the disease compared to those from more affluent areas. These factors have lead to bowel cancer patients from deprived areas being more likely to die within 30 days of having surgery.

Raymond Oliphant, lead researcher and a clinical research fellow based at the University of Glasgow’s West of Scotland Cancer Surveillance Unit, said: “This research further highlights that survival following treatment for bowel cancer is better in people from the most affluent areas and worst among the most deprived.

“This study builds on previous research in this area by giving more detail on both short and longer term survival differences between patients from different economic backgrounds and will help those working on ways to improve outcomes for bowel cancer patients.”

When researchers excluded patients who died within the first 30-days of surgery from their analysis, they found no difference in survival between socioeconomic groups.
This suggests that the biggest impact on survival between deprived and affluent patients happens in the very first few weeks after surgery.

Chris Carrigan, head of the NCIN, said: “This study once again stresses the urgent need to improve the health of people living in deprived areas and to make sure all cancer patients have an equal chance of surviving their cancer.

“Deprivation is one of the biggest causes of cancer inequality in this country. We know that people from more deprived areas are more likely to smoke or be very overweight. They are also less likely to be aware of signs and symptoms of cancer, probably leading to later diagnosis, which may further increase their chances of dying from their disease.

“We need to take a close look at factors like late diagnosis, uptake of screening and variations in treatment for people from different social and economic backgrounds if we are to reduce inequality in cancer survival.

“But in the meantime everyone can do their bit by giving up smoking, which increases the risk of other diseases which affect the outcome of surgery, eating sensibly and seeing a GP as soon as possible if they notice anything unusual about their body.”

ENDS

For media enquiries please contact the NCIN press office on 020 3469 8300 or, out-of-hours, the duty press officer on 07050 264 059.

1. Oliphant, R et al,. The influence of socioeconomic circumstances on survival after surgery for colorectal cancer (2012)