PT  - JOURNAL ARTICLE
AU  - Syriopoulou, Elisavet
AU  - Osterman, Erik
AU  - Miething, Alexander
AU  - Nordenvall, Caroline
AU  - Andersson, Therese Marie-Louise
TI  - Income disparities in loss in life expectancy after colon and rectal cancers: a Swedish register-based study
AID  - 10.1136/jech-2024-221916
DP  - 2024 Jun 01
TA  - Journal of Epidemiology and Community Health
PG  - 402--408
VI  - 78
IP  - 6
4099  - http://jech.bmj.com/content/78/6/402.short
4100  - http://jech.bmj.com/content/78/6/402.full
SO  - J Epidemiol Community Health2024 Jun 01; 78
AB  - Background Differences in the prognosis after colorectal cancer (CRC) by socioeconomic position (SEP) have been reported previously; however, most studies focused on survival differences at a particular time since diagnosis. We quantified the lifetime impact of CRC and its variation by SEP, using individualised income to conceptualise SEP.Methods Data included all adults with a first-time diagnosis of colon or rectal cancers in Sweden between 2008 and 2021. The analysis was done separately for colon and rectal cancers using flexible parametric models. For each cancer and income group, we estimated the life expectancy in the absence of cancer, the life expectancy in the presence of cancer and the loss in life expectancy (LLE).Results We found large income disparities in life expectancy after a cancer diagnosis, with larger differences among the youngest patients. Higher income resulted in more years lost following a cancer diagnosis. For example, 40-year-old females with colon cancer lost 17.64 years if in the highest-income group and 13.68 years if in the lowest-income group. Rectal cancer resulted in higher LLE compared with colon cancer. Males lost a larger proportion of their lives. All patients, including the oldest, lost more than 30% of their remaining life expectancy. Based on the number of colon and rectal cancer diagnoses in 2021, colon cancer results in almost double the number of years lost compared with rectal cancer (24 669 and 12 105 years, respectively).Conclusion While our results should be interpreted in line with what individualised income represents, they highlight the need to address inequalities.Data may be obtained from a third party and are not publicly available. This study analysed data from the CRCBaSe. Restrictions apply to the availability of these data and so are not publicly available. However, data requests can be send to the relevant quality registry for CRC: https://cancercentrum.se/samverkan/cancerdiagnoser/tjocktarm-andtarm-och-anal/tjock--och-andtarm/kvalitetsregister/forskning/forskningsdatabas/.