The influence of geographical access to health care and material deprivation on colorectal cancer survival: Evidence from France and England

O. Dejardin 1, * A.P. Jones 2 B. Rachet 3 E. Morris 4 Véronique Bouvier 1 V. Jooste 5 E. Coombes 2 D. Forman 4, 6 A.M. Bouvier 5 Guy Launoy 1
* Corresponding author
1 Cancers et préventions
2 UEA - University of East Anglia [Norwich]
3 LSHTM - London School of Hygiene and Tropical Medicine
4 University of Leeds
5 Registre Bourguignon des Cancers Digestifs
LNC - Lipides - Nutrition - Cancer (U866), CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
6 CIRC - IARC - Centre International de Recherche contre le Cancer - International Agency for Research on Cancer
Abstract : This article investigates the influence of distance to health care and material deprivation on cancer survival for patients diagnosed with a colorectal cancer between 1997 and 2004 in France and England. This population-based study included all cases of colorectal cancer diagnosed between 1997 and 2004 in 3 cancer registries in France and 1 cancer registry in England (N=40,613). After adjustment for material deprivation, travel times in England were no longer significantly associated with survival. In France patients living between 20 and 90min from the nearest cancer unit tended to have a poorer survival, although this was not statistically significant. In England, the better prognosis observed for remote patients can be explained by associations with material deprivation; distance to health services alone did not affect survival whilst material deprivation level had a major influence, with lower survival for patients living in deprived areas. Increases in travel times to health services in France were associated with poorer survival rates. The pattern of this influence seems to follow an inverse U distribution, i.e. maximal for average travel times.
Keywords : England material deprivation colorectal cancer France travel times survival Health care accessibility
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UNIV-BOURGOGNE | LNC-UMR866 | COMUE-NORMANDIE | UNICAEN | U1086

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O. Dejardin, A.P. Jones, B. Rachet, E. Morris, Véronique Bouvier, et al.. The influence of geographical access to health care and material deprivation on colorectal cancer survival: Evidence from France and England. Health & Place, Elsevier, 2014, 30, pp.36 - 44. ⟨10.1016/j.healthplace.2014.08.002⟩. ⟨inserm-01870353⟩

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