Cancer survival depends on where you live

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In poorer socio-economic regions, the chances of cancer survival deteriorating

According to a study by the German Cancer Research Center (DKFZ), the chance of surviving cancer depends on the patient's place of residence within Germany. In some regions, people diagnosed with cancer appear to die earlier than elsewhere. According to the experts, this applies equally to all types of cancer.

Richer region lowers mortality
If you want to survive a cancer diagnosis, you will have to undergo serious interventions and therapies in most cases. But unfortunately it does not apply that the chances of survival within Germany are roughly good or bad. An evaluation by the German Cancer Research Center in Heidelberg came to the conclusion that people in poorer economic areas have less chance of recovery than in richer regions. "This is especially true for the first three months after cancer diagnosis," said the doctors. In order to undertake the study, around one million patient data from cancer patients were evaluated.

Other studies have already indicated that patients with a higher income and status have better chances of recovery than cancer patients who come from poorer classes. However, there have not yet been any meaningful studies in this direction for Germany. In the DKFZ, scientists led by Professor Hermann Brenner investigated this question in detail for the first time. But now the scientists evaluated the data sets from ten of the 16 German state cancer registries. The researchers focused on the 25 most common cancers that occurred in about one million people between 1997 and 2006. The individual counties were then examined for the average income situation. The key factors in the socio-economic evaluation were the average per capita income, the unemployment rate and the municipal income and expenditure balance sheets. The result: "Patients from the socio-economically weakest fifth of the counties died significantly earlier after their diagnosis than cancer patients from the other gene regions".

A third less chance of survival
According to the research team, the difference was most noticeable in the first three months after the fateful diagnosis was made. Measured against the 25 most common types of cancer, patients from regions with poorer economies showed a 33 percent reduction in survival. At about nine months after the cancer diagnosis, the difference was still 20 percent. And after four years, people from richer regions survived 16 percent more.

However, the study did not clarify why this is the case. According to the experts, the results do not necessarily indicate that the individual situation of the patient is responsible for this. Rather, there are many indications that the characteristics of the respective region are responsible. In weaker regions, for example, the exposed cancer treatment clinics may be more difficult to reach, or there may simply be fewer places in the centers.

Reasons not yet sufficiently confirmed
The first assumption that people in socio-economically poorer regions take less preventive care on average has not been confirmed in the course of the study. It could have been that the cancer was only detected at a late stage and therefore the chance of survival is reduced. "But that's not the reason: The differences in survival remain if we take the stage distribution into account in the evaluation," writes Lina Jansen, author of the study.

"It is imperative that we find out the cause of the increased mortality among patients from weaker socio-economic regions," warned Professor Otmar D. Wiestler, CEO of the German Cancer Research Center. "Only if we know the reasons can we do something specifically to ensure that all cancer patients in Germany have the same chance." With more than 2,500 employees, the German Cancer Research Center (DKFZ) is the largest biomedical research facility in Germany. Over 1,000 scientists at the DKFZ are researching how cancer develops, recording cancer risk factors and looking for new strategies that prevent people from getting cancer. (sb)

Image: Rainer Sturm /

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