Differentials in survival for childhood cancer in Australia by remoteness of residence and area disadvantage

Youlden, Danny R., Baade, Peter D., Valery, Patricia C., Ward, Leisa J., Green, Adele C. and Aitken, Joanne F. (2011) Differentials in survival for childhood cancer in Australia by remoteness of residence and area disadvantage. Cancer Epidemiology Biomarkers and Prevention, 20 8: 1649-1656. doi:10.1158/1055-9965.EPI-11-0432


Author Youlden, Danny R.
Baade, Peter D.
Valery, Patricia C.
Ward, Leisa J.
Green, Adele C.
Aitken, Joanne F.
Title Differentials in survival for childhood cancer in Australia by remoteness of residence and area disadvantage
Journal name Cancer Epidemiology Biomarkers and Prevention   Check publisher's open access policy
ISSN 1055-9965
1538-7755
Publication date 2011-08-01
Year available 2012
Sub-type Article (original research)
DOI 10.1158/1055-9965.EPI-11-0432
Open Access Status Not Open Access
Volume 20
Issue 8
Start page 1649
End page 1656
Total pages 8
Place of publication Philadelphia, PA, United States
Publisher American Association for Cancer Research
Language eng
Formatted abstract
Background: It is not known whether improvements in cancer survival over recent decades have benefited children from different geographic locations equally. This is the first study to produce national survival estimates for childhood cancer in Australia by remoteness of residence and area-based socioeconomic status.
Methods: The study utilized population-based data from the Australian Paediatric Cancer Registry for children diagnosed with cancer from 1996 onward who were at risk of mortality between January 2001 and December 2006 (n = 6,289). Remoteness was specified according to the Australian Standard Geographical Classification Remoteness Areas, whereas an index of area disadvantage was obtained from census information. Five-year relative survival estimates were produced by the period method for all cancers and the most common diagnostic groups, with corresponding age–sex adjusted mortality hazard ratios calculated using Poisson regression.
Results: Overall, children with cancer from remote/very remote areas had a significantly lower survival rate than their counterparts in major cities (HR = 1.55, 95% CI = 1.08–2.23). Survival was also lower for children with leukemia living in inner regional (HR = 1.52, 95% CI = 1.11–2.08) or outer regional areas (HR = 1.53, 95% CI = 1.03–2.28). There was weak evidence (Pgrad = 0.051) of a trend toward poorer survival by greater area disadvantage for all childhood cancers.
Conclusions: Some variation in prognosis by place of residence was present for children with cancer in Australia, particularly among leukemia patients.
Impact: Treatment, clinical or area-related factors that contribute to these survival differentials need to be identified.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Public Health Publications
 
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