Factors driving inequality in prostate cancer survival: A population based study

Study reveals that the role of healthcare providers and socio-economic status in survival of men with prostate cancer could give rise to concerns that warrant further investigation.

A recently published paper in PLOS ONE, written by researchers at the University of Oxford, NUI Galway and the National Cancer Registry Ireland (NCRI), examined the role of a range of clinical and socio-demographic variables in explaining variations in all-cause mortality after a prostate cancer diagnosis, paying particular attention to the role of healthcare provider(s) i.e. private versus public status.

The study, funded by the Health Research Board, and using NCRI data, assessed survival trends among patients diagnosed with prostate cancer from 1998-2009 (N=26,183). Several factors were investigated for impact on overall survival including healthcare provider, socio-economic status, marital and smoking status, area of residence as well as cancer stage and grade.

The findings suggest patients treated in a private healthcare setting had, on average, a 40% reduced risk of all-cause mortality compared to those who were treated solely in the public setting, when adjusted for age and clinical variables.

Given the high incidence of prostate cancer in the Republic of Ireland and internationally, a better understanding of the determinants of survival will provide policy makers and healthcare professionals with evidence to improve both access to, and delivery of care. However, while we found that a socio-economic gradient was evident, the magnitude of the effect differed considerably in the different follow-up times and sub-groups. While the results with respect to healthcare provision may give rise to concerns about equitable delivery of care; care is warranted in the interpretation of these findings and further analysis is required to establish whether concerns are legitimate.


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