Poor more likely to get cancer and die from it: British study

PHOTO: Poor more likely to get cancer and die from it: British study

SINGAPORE - The poorer you are, the higher your risk of getting cancer - and dying of it.

This was the finding of British government agency Public Health England - and although there are no similar studies here, experts say the situation is likely to be the same.

They say poorer people could be less likely to seek medical help as they believe they cannot afford it - despite help schemes being available - and could also face higher risks because of their lifestyle or diet.

Released last month, the study found that both incidence and death for all cancers combined were higher in the more deprived 20 per cent of the population than in the top quintile.

Not only do 15,300 more in the poorest fifth of people have cancer each year, about 19,200 more of them die from cancer than people in the top economic quintile.

Researchers studied cancer diagnosed in Britain from 2006 to 2010 and deaths from 2007 to 2011.

Professor Chia Kee Seng, head of the Saw Swee Hock School of Public Health at the National University of Singapore, said: "It is highly likely that we will have similar findings."

Dr Francis Chin, a senior consultant at the National Cancer Centre Singapore, agreed it would be a similar case here, despite the availability of highly subsidised health screening and treatment. "In Britain, accessibility and affordability of medical treatment is not an issue," he said.

"Anecdotally, this situation may arise because the poor are less empowered and poorly informed of the various help schemes. A factor preventing people from coming to the hospital is the perceived expense of medical treatment, so they delay seeking help and may consequently have more advanced tumours and lesser cure rates."

The British study revealed that the bulk of cancer cases and deaths were from lung cancer, with 11,700 more such cases in the lowest economic quintile compared to the top fifth, and 9,900 more deaths per year.

It said that other smoking-related cancers, such as of the throat and mouth, "also had strong associations between deprivation and incidence or mortality".

Prof Chia said: "Smoking, the major risk factor for cancer, is associated with lower social economic strata in many populations."

Dr Jeremy Lim, a partner in Oliver Wyman - a group that provides consultancy services including health care - said "the poor are disadvantaged in every piece of the continuum" from prevention and early screening to appropriate treatment and follow-up. Healthy food usually costs more, he said and "screening take-up is higher among higher-educated and more affluent" people.

He added that cancer medicine can be expensive, even with subsidy, "and this may deter full treatment".

But Dr Chin disagreed: "The access to health care is not determined by ability to pay as there are Medisave, MediShield and Medifund for those who are unable to pay."

Dr Lim called for similar studies to be carried out in Singapore. He said: "It is undoubtedly a very important issue and I do hope that policymakers and academics are actively researching and tracking, even if they do not release the data into the public domain."

Prof Chia said such research could be carried out through the Singapore Cancer Registry.

salma@sph.com.sg


This article was first published on June 16, 2014.
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