Low Incomes Leads to Higher Mortality Rate In Prostate Cancer Patients

GENEVA – Prostate cancer patients who belong to low socio-economic status are more likely to die than patients with higher incomes, according to a new study from Swiss researchers.

The study’s findings indicate that poor prostate cancer patients receive worse care than their wealthier counterparts.

The researchers wanted to know how disparities affected prostate cancer mortality in Switzerland, a country with an extremely well developed health care system and where healthcare costs, medical coverage, and life expectancy are among the highest in the world,

Dr. Elisabetta Rapiti, of the University of Geneva, and her colleagues conducted a population-based study that included all residents of the region who were diagnosed with invasive prostate cancer between 1995 and 2005.

The analysis included 2,738 patients identified through the Geneva Cancer Registry.

The researchers found that as compared with patients of high socio-economic status, those of low socio-economic status were less likely to have their cancer detected by screening, had more advanced stages of cancer at diagnosis, and underwent fewer tests to characterize their cancer.

These patients were less likely to have their prostates removed and were more likely to be managed with watchful waiting, or careful monitoring.

Patients with low socio-economic status also had a 2-fold increased risk of dying from prostate cancer compared with patients of high socio-economic status.

“The increased mortality risk of patients of low socio-economic status is almost completely explained by delayed diagnosis, poor work-up, and less complete treatment, indicating inequitable use of the health care system,” said Rapiti.

The authors say lead time and length time biases linked to early detection through PSA screening may partially explain the survival advantage observed among high SES patients.

The study has been published in the latest issue of Cancer, a peer-reviewed journal of the American Cancer Society.

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