Cancer conundrum: Poorer Canadians less likely to survive cancer


VanIsle
#1
Why do you think this is happening?

TORONTO - Cancer patients from poor neighbourhoods have a greater chance of dying prematurely than their wealthier counterparts, says a new study, describing a problem that persists despite universal health care in Canada.
Much of the literature on the topic, especially in the United States, has partially explained this disparity by saying it is due to the fact that poorer people are diagnosed when their cancer is at a later stage. But this particular study of Ontario patients didn't find that to be the case.
"I think a lot of us were attributing much more of an impact of the stage at diagnosis, and this study really has highlighted that no, that's not the major factor," Heather Chappell, director of cancer control policy at the Canadian Cancer Society, said in reaction to the findings.
Chappell said it means researchers and the medical community need to be looking at what other reasons might be at play.
"There still is a survival disparity and we need to work to understand why that is the case and to correct that difference in outcome," agreed lead researcher Dr. Christopher Booth of the Queen's University Cancer Research Institute.
The study was published online Monday in Cancer, a journal of the American Cancer Society.
It looked at median household incomes from the 2001 Canadian census and used the Ontario Cancer Registry to identify patients diagnosed from 2003 to 2007.
The chance of a woman from a poor community being alive five years after diagnosis of breast cancer is 77 per cent, compared to 84 per cent for affluent women, Booth said.
Fifty-two per cent of patients with colorectal cancer from the lowest socioeconomic groups are alive five years after diagnosis, compared to 60 per cent of those in the most affluent communities.
"These are important and meaningful differences," Booth said in an interview from Kingston, Ont.
"If we had a form of chemotherapy or cancer treatment that led to an improvement or difference in five-year survival of seven, eight, nine per cent the order of magnitude we're seeing with these differences it would be a blockbuster home run as far as cancer treatment advances."
As for the fact that there were only modest differences in stage of diagnosis, Booth said it could be because the universal health care system allows Canadians of all economic backgrounds to have access to screening and specialists.
With stage of diagnosis being pretty well discounted as a factor in the disparity, it leaves researchers wondering why the differences in outcome do exist between income levels.
"If it's not stage of disease, what's driving this? And there's a whole host of factors, so it might be at the tumour level. It might be that people with different backgrounds have more aggressive biology in their disease. It might be other aspects of health that are correlated with socioeconomic status," Booth said.
Chappell agreed, noting that people with lower socioeconomic status have more co-morbidities other types of disease that may have an impact on their cancer treatment.
"And smoking rates may be another significant fact. And what was interesting was in the study they looked at six specific types of cancers, and every one of them is related to tobacco use," she observed.
In addition, she pointed to a cancer drug access report last year that showed one in 12 Canadians face catastrophic drug costs, and people with lower incomes and seasonal and self-employed workers usually don't have access to affordable insurance for those cancer drugs.
"So we already have identified that as a problem, and we've been advocating the federal and provincial governments to work together to create a national catastrophic drug program," Chappell said.
Mary McBride, senior epidemiologist at the B.C. Cancer Agency, said researchers need to take a more in-depth look at factors that might fit under the broad umbrella of socioeconomic status, such as income and education levels, number of years they've been in Canada and potential language barriers.
"Their health-seeking behaviours and their familiarity with the health system might affect their ongoing care and subsequent survival," she said from Vancouver.
McBride noted that the study only looked at data for cancer patients being treated at eight regional cancer centres in Ontario, and it would be interesting to look at the entire cancer population in the province, and Canada.
Chappell also said more research is needed to see if the findings would be the same in other provinces, and to identify factors that may be having an impact on survival.
"Once we have a better understanding of those factors affecting survival, programs that are effective at addressing those would have a better chance of affecting survival for those patients."
 
petros
#2
Dieing ain't cheap.
 
taxslave
#3
There are many factors at work here. Poor people tend to have poorer diets which is not good when the body is already in distress. Probably a higher alcohol and tobacco consumption and less general physical condition. Could be a general case of less overall care for their body and mind as well.
 
Cliffy
#4
I find it interesting that the cancer society needs to make another study on the obvious. Cancer is big business. None of those clowns wants to lose their job by providing a cure. Cancer is curable and it isn't expensive.
We have all heard the expression, "Anger will eat you up inside." Some people have cured themselves by just changing their attitudes.
 
petros
#5
Or by laying off high fructose corn syrup laced products. Cancer loves sugars.
 
taxslave
#6
Quote: Originally Posted by Cliffy View Post

I find it interesting that the cancer society needs to make another study on the obvious. Cancer is big business. None of those clowns wants to lose their job by providing a cure. Cancer is curable and it isn't expensive.
We have all heard the expression, "Anger will eat you up inside." Some people have cured themselves by just changing their attitudes.

Too true. Big Pharma has no interest in curing diseases, only maintaining a steady supply of purchasers for their product.
A friend of ours that recently died battled cancer for years and she had no use for the Cancer society at all. Called them a bunch of money sucking pigs.
 
Cliffy
#7
Quote: Originally Posted by taxslave View Post

Too true. Big Pharma has no interest in curing diseases, only maintaining a steady supply of purchasers for their product.
A friend of ours that recently died battled cancer for years and she had no use for the Cancer society at all. Called them a bunch of money sucking pigs.

I would rather die on my terms than to be one of their Guinea pigs. My brother died of cancer in 2000. I had him off all drugs and he was doing well. But he could not answer the question as to whether or not he wanted to live. In the end he decided that he didn't and went back to Prince George (the cancer capital of Canada) to die. He knew what he was doing. His last words to me were that it was too hard to give up his anger, that he would figure it out in the next life.
 
taxslave
#8
My mother did the same in the early 80s.
Perhaps his anger was left over from his previous life that he never resolved?
 
Cliffy
#9
Quote: Originally Posted by taxslave View Post

My mother did the same in the early 80s.
Perhaps his anger was left over from his previous life that he never resolved?

That is a distinct possibility. I neglected to tell him it would be twice as hard the next time because he had made up his mind and didn't want to hear about it.
 
VanIsle
#10
Quote: Originally Posted by taxslave View Post

There are many factors at work here. Poor people tend to have poorer diets which is not good when the body is already in distress. Probably a higher alcohol and tobacco consumption and less general physical condition. Could be a general case of less overall care for their body and mind as well.

I also felt this was the obvious answer but I wanted someone else to state it first. Perhaps the cancer society should quiz cashiers regarding peoples purchases and they will have their answer. I used to feel so bad for some of the customers. Men in particular shared the fact that they had cancer. It's not a good feeling to be the stranger on the other side of the counter without time to listen to or offer much in the way of words of comfort when receiving such information. People go through tills with mounds of "bad for you" type foods. The truly odd thing is that when they find out they don't have enough money to pay for their full purchase, the stuff they gave back was the healthy food.

Quote: Originally Posted by taxslave View Post

My mother did the same in the early 80s.
Perhaps his anger was left over from his previous life that he never resolved?

In 4 more day, it would have been the birthday of my deceased sister. She was angry with me for years. To this day I don't know why. My oldest brother told me not to go and visit her in hospital when she was dying as he said she was lashing out at almost anyone who came in and he felt she would really lash out at me, hurting my feelings even more than ever. Maybe the anger she carried to her grave is something she and I will resolve in our next life. I believe our next life will be as sisters again.
 
AnnaG
#11
Quote: Originally Posted by VanIsle View Post

Why do you think this is happening?

TORONTO - Cancer patients from poor neighbourhoods have a greater chance of dying prematurely than their wealthier counterparts, says a new study, describing a problem that persists despite universal health care in Canada.
Much of the literature on the topic, especially in the United States, has partially explained this disparity by saying it is due to the fact that poorer people are diagnosed when their cancer is at a later stage. But this particular study of Ontario patients didn't find that to be the case.
"I think a lot of us were attributing much more of an impact of the stage at diagnosis, and this study really has highlighted that no, that's not the major factor," Heather Chappell, director of cancer control policy at the Canadian Cancer Society, said in reaction to the findings.
Chappell said it means researchers and the medical community need to be looking at what other reasons might be at play.
"There still is a survival disparity and we need to work to understand why that is the case and to correct that difference in outcome," agreed lead researcher Dr. Christopher Booth of the Queen's University Cancer Research Institute.
The study was published online Monday in Cancer, a journal of the American Cancer Society.
It looked at median household incomes from the 2001 Canadian census and used the Ontario Cancer Registry to identify patients diagnosed from 2003 to 2007.
The chance of a woman from a poor community being alive five years after diagnosis of breast cancer is 77 per cent, compared to 84 per cent for affluent women, Booth said.
Fifty-two per cent of patients with colorectal cancer from the lowest socioeconomic groups are alive five years after diagnosis, compared to 60 per cent of those in the most affluent communities.
"These are important and meaningful differences," Booth said in an interview from Kingston, Ont.
"If we had a form of chemotherapy or cancer treatment that led to an improvement or difference in five-year survival of seven, eight, nine per cent the order of magnitude we're seeing with these differences it would be a blockbuster home run as far as cancer treatment advances."
As for the fact that there were only modest differences in stage of diagnosis, Booth said it could be because the universal health care system allows Canadians of all economic backgrounds to have access to screening and specialists.
With stage of diagnosis being pretty well discounted as a factor in the disparity, it leaves researchers wondering why the differences in outcome do exist between income levels.
"If it's not stage of disease, what's driving this? And there's a whole host of factors, so it might be at the tumour level. It might be that people with different backgrounds have more aggressive biology in their disease. It might be other aspects of health that are correlated with socioeconomic status," Booth said.
Chappell agreed, noting that people with lower socioeconomic status have more co-morbidities other types of disease that may have an impact on their cancer treatment.
"And smoking rates may be another significant fact. And what was interesting was in the study they looked at six specific types of cancers, and every one of them is related to tobacco use," she observed.
In addition, she pointed to a cancer drug access report last year that showed one in 12 Canadians face catastrophic drug costs, and people with lower incomes and seasonal and self-employed workers usually don't have access to affordable insurance for those cancer drugs.
"So we already have identified that as a problem, and we've been advocating the federal and provincial governments to work together to create a national catastrophic drug program," Chappell said.
Mary McBride, senior epidemiologist at the B.C. Cancer Agency, said researchers need to take a more in-depth look at factors that might fit under the broad umbrella of socioeconomic status, such as income and education levels, number of years they've been in Canada and potential language barriers.
"Their health-seeking behaviours and their familiarity with the health system might affect their ongoing care and subsequent survival," she said from Vancouver.
McBride noted that the study only looked at data for cancer patients being treated at eight regional cancer centres in Ontario, and it would be interesting to look at the entire cancer population in the province, and Canada.
Chappell also said more research is needed to see if the findings would be the same in other provinces, and to identify factors that may be having an impact on survival.
"Once we have a better understanding of those factors affecting survival, programs that are effective at addressing those would have a better chance of affecting survival for those patients."

I've been saying this for years along with the fact that if one is wealthier one gets better healthcare.

Quality of life (better food quality and that sort of thing), stress (usually money-related), and perhaps higher quality medical staff.
 
gerryh
#12
who cares
 
lone wolf
#13
Not the family who lives with it or the person who hosts the demon that's for sure....
Note the sarcastic purple....
 
AnnaG
#14
Quote: Originally Posted by petros View Post

Or by laying off high fructose corn syrup laced products. Cancer loves sugars.

Cancer Update Email -- It's a Hoax!

Quote: Originally Posted by gerryh View Post

who cares

Obviously you do or else you'd have ignored this thread.
 
mclarty55
#15
You raise an interesting point.
 
JLM
#16
Quote: Originally Posted by taxslave View Post

There are many factors at work here. Poor people tend to have poorer diets which is not good when the body is already in distress. Probably a higher alcohol and tobacco consumption and less general physical condition. Could be a general case of less overall care for their body and mind as well.

Absolutely correct taxslave. There are many reasons why people are poor, but one of them is lack of self discipline, they don't always attend to things in a timely manner, which can be a direct cause of their poverty..........paying interest on over due accounts, maybe they put off routine physical tests (that would have detected the cancer 6 months sooner. Maybe they put off doing their exercises (which has been proven to reduce cancer risks) When you are in the peak of health any digression from the norm is immediately noticeable, when you are sick all the time, changes aren't as noticible. Staying healthy is hard work but the benefits are well worth the effort. Keeping my fingers crossed...............
 
Tonington
#17
Only three provinces fund 100% of the costs for cancer drugs: BC, Alberta, and Saskatchewan.

Universal healthcare doesn't mean universal drug coverage. Most cancer drug treatments cost over $20,000 a year. Who is going to survive longer? Those who can afford to obviously.
 
EagleSmack
#18
Quote: Originally Posted by Tonington View Post

Only three provinces fund 100% of the costs for cancer drugs: BC, Alberta, and Saskatchewan.

Universal healthcare doesn't mean universal drug coverage. Most cancer drug treatments cost over $20,000 a year. Who is going to survive longer? Those who can afford to obviously.

So Canada has Universal Health Care but the Meds are separate?
 
JLM
#19
Quote: Originally Posted by EagleSmack View Post

So Canada has Universal Health Care but the Meds are separate?

I believe "Universal Health Care" is just a phrase and doesn't fully describe the system.
 
Tonington
#20
Quote: Originally Posted by EagleSmack View Post

So Canada has Universal Health Care but the Meds are separate?

Yup. Diagnosis free, treatment, not always. Drugs are covered for some groups by the Federal government, some drugs are covered by Provincial health plans. I have group insurance from Sun Life through my employer, that covers me and my fiance. Drugs, eye care, dental, physio, orthopedics...a lot of coverage. It's a very good plan.
 

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