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Br J Cancer. 2008 Dec 2;99(11):1923-8. doi: 10.1038/sj.bjc.6604743. Epub 2008 Oct 28.

No socioeconomic inequalities in colorectal cancer survival within a randomised clinical trial.

Collaborators (173)

Miller R, Dewar EP, Kapadia CR, Nejim A, Hutchinson IF, McAdam WA, Morris IR, Deasy JM, Irwin ST, Oates GD, O'Dwyer ST, Dorricott NJ, Stock SE, Wilkinson MJ, Ostick DG, Hobbiss JH, Farrands PA, Ross AH, Sauven P, Sandilands DG, De Castella HC, McCarthy D, Lee P, Allen-Mersh TG, Haynes S, Bristol JB, Donovan IA, Neoptolemos JP, Wolverson RL, Silverman SH, Lee M, Backhouse C, Millar DM, Kirwan WO, Edwards P, Morran CG, Maddox C, Palmer JG, Nicoll J, Jacob GH, Archbold JA, Bell JC, Rennie JA, Turner AR, Turner J, Fearon KC, Vaar A, Ratsep V, Nasmyth DG, McKee RF, Cooke TG, McArdle C, Stephenson RF, Baxter NJ, Rew DA, Thomson WH, Gear MW, Allan A, Pearson HJ, Goldberg PA, Kmiot WA, Irving MH, Bancewicz J, Mughal M, Jones DJ, Kipping RA, Dudley NE, Mortensen NJ, Parker M, Armistead PR, Gillison EW, Loughlin V, Kelly MJ, Mosley J, Cade D, Guy A, Moorehead J, Harvey CF, Parisi VP, Delrio P, Jones DR, Bozzino JM, Griffin SM, Griffith CD, Bulman A, Stebbings WS, Deakin M, Adab F, Goulbourne IA, Berry AR, Cunningham FO, Ingoldby CJ, Talbot R, Burgess P, Stamatakis J, Offori T, Cullen PT, Logie JR, Thomson A, Maybury NK, Fozard BJ, Cooper MJ, Vellacott KD, Shorthouse AJ, Poston GJ, Simkin EP, McIntosh HR, Karran DR, Royle GT, Karanjia N, Marks CG, Maxwell RJ, Varma JS, Simson JN, Burkitt D, Johnson CD, Steer HW, Primrose JN, McGinn FP, Taylor I, Zeiderman MR, Sagor GR, Hawley P, Northover JM, Donaldson DR, Scott HJ, Gallagher P, Crossling FT, McKelvey ST, Rickett JW, Kingston RD, Davidson T, Boulos PB, Smith DC, Smith IS, Gillespie G, Kashi SH, Grieve RJ, Fraser IA, Roberts PN, Lam FT, Parker RW, Stockdale A, Jurewicz A, Woodward DA, Taylor BA, Thomas JM, Sarin S, Reilly DT, Stebbings W, Hamer-Hodges DW, Nixon SJ, Saunders JH, Macintyre IM, Yosef H, Smith AN, Lock MR, Lake SP, Smart PJ, Grimley R, Hall R, Jamison MH, Jenkinson LR, James RD, Donaldson D, Gray R, Stenning SP, Garten L, McQueen A, Simnett S, Johnstone C, Cain D, Lallemand E.

Author information

Cancer Research UK Cancer Survival Group, Non-Communicable Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK.


There is strong evidence that colorectal cancer survival differs between socioeconomic groups. We analysed data on 2481 patients diagnosed during 1989-1997 and recruited to a randomised controlled clinical trial (AXIS, ISRCTN32414363) of chemotherapy and radiotherapy for colorectal cancer. Crude and relative survival at 1 and 5 years was estimated in five categories of socioeconomic deprivation. Multiple imputation was used to account for missing data on tumour stage. A multivariable fractional polynomial model was fitted to estimate the excess hazard of death in each deprivation category, adjusting for the confounding effects of age, stage, cancer site (colon, rectum) and sex, using generalised linear models. Relative survival in the trial patients was higher than in the general population of England and Wales. The socioeconomic gradient in survival was much smaller than that seen for colorectal cancer patients in the general population, both at 1 year -3.2% (95% CI -7.3 to 1.0%, P=0.14) and at 5 years -1.7% (95% CI -8.3 to 4.9%, P=0.61). Given equal treatment, colorectal cancer survival in England and Wales does not appear to depend on socioeconomic status, suggesting that the socioeconomic gradient in survival in the general population could well be due to health-care system factors.

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