Hot off the
press is a well written exploration of disparities in outcome related to cancer
management in Canada. Produced by the Canadian
Partnership Against Cancer who have effectively advocated and received funding
to improve cancer outcomes nationally, and includes most of the provincial cancer
control agencies augmented by the Canadian Cancer Society (although the actual
partners are not listed on their Website home) . The maintain a wealth of excellent
information and surfing their site is worth a few minutes.
Perhaps it
is notable that the disparities report is not yet locatable on the Partnership
website, but can be accessed at Disparities
in Cancer Control. The 75 page
report delves into the inequities carried by lower income, rural and remote
residents, new immigrants, and carefully skirts First nations issues.
The reading
is not for the average Canadian, with a degree in epidemiology an asset. However most public health professionals will
be able to appreciate the tabulations against the three identified groups by; cancer
risk factors, access to cancer screening, from screening to resolution for
breast cancer, incidence and mortality from stage comparable cancers, time of treatment, type of treatment (eg
mastectomy versus breast conserving surgery), clinical trial participation, and
finally a specific section on survival.
While the
majority of findings are not surprising in that those in lower income groups,
those living in rural and remote areas, and those geographic areas with higher
proportions of immigrants tend to be associated with measures that are
relatively poorer, there are some surprises.
Notably are some of the relationships between risk factors which in this
study puts smoking and alcohol consumption, and obesity rates higher in higher
income groups, and generally lower in immigrant populations.
While not
yet a full exploration of the impacts of determinants of health on cancer, it
is a step in the right direction, and well worth keeping a copy for
reference.
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