1744P - Socioeconomic inequalities in the diagnosis and treatment of colon cancer: A population-based English cancer registry study

Background

Patients with colon cancer from more deprived areas may face barriers to accessing timely, quality healthcare. These barriers may contribute to socioeconomic inequalities in survival. We examined differences in treatment and time to diagnosis and treatment between socioeconomic groups.

Methods

The English Cancer Registry identified a retrospective cohort of patients diagnosed with colon cancer in England between 2016-2017. Cancer Registry data were linked to Hospital Episode Statistics, Cancer Pathway, Systematic Anti-Cancer Dataset and Diagnostic Imaging Datasets. Lasso logistic regression identified predictors of colon cancer treatment. The secondary care diagnostic interval (SCDI) was used to calculate the time to diagnosis and treatment, analysed using quantile regression. All analyses were conducted using STATA. The study was registered on ClinicalTrials.gov (NCT05185388).

Results

A total of 35,248 patients were included in the analyses. Area deprivation was a significant predictor of receipt of surgery and chemotherapy. The adjusted odds of treatment were reduced for patients from the most deprived quintile: surgery (OR 0.78), chemotherapy in stage IV (OR 0.88), and chemotherapy in stage II-III (OR 0.79). The median SCDI was 20 days for patients from the most and least deprived areas. However, patients from the most deprived area had a significantly longer time to diagnosis after adjusting for other factors (median difference 0.73 days [95% CI 0.09-1.36]). Meanwhile, the median treatment interval was 55 and 57 days for patients from the least and most deprived areas, respectively. The treatment interval was significantly longer for patients from the most, compared with the least deprived areas after adjusting for important factors (median difference 2.29 days [95% CI 1.28-3.31]).

Conclusions

In this large cohort of patients with colon cancer in England, we demonstrated that patients from more deprived areas are less likely to receive surgery or chemotherapy and wait longer to commence treatment. Further research is needed to understand why and what evidence-based actions can reduce these inequalities in treatment and timeliness.

Clinical trial identification

NCT05185388.

Editorial acknowledgement

Legal entity responsible for the study

University of Hull.

Funding

Yorkshire Cancer Research.

Disclosure

All authors have declared no conflicts of interest.