Disparities in cancer survival by socioeconomic status: findings from a population-based study of 942 241 Australians from 1980 to 2019

Cancer survival in Australia has improved over time, but disparities by socioeconomic status persist. We analyzed data from the population-wide New South Wales Cancer Registry, including 942 241 individuals with invasive solid cancers diagnosed between 1980 and 2019. We examined cancer-specific and all-cause deaths by area-based socioeconomic status for all solid cancers and 12 common cancers using competing risks regression alongside crude survival. Five-year cancer-specific survival for all cancers improved from 50.3% in 1980-1989 to 73.3% in 2010-2019. Risk of cancer death was higher for individuals living in most socioeconomically disadvantaged areas (vs least disadvantaged areas), and differences increased over time: from a sub-hazard ratio of 1.04 (95% CI = 1.02 to 1.07) in 1980-1989 to 1.35 (95% CI = 1.32 to 1.38) in 2010-2019 (adjusting for age, sex, cancer type, cancer spread). Statistically significant and increasing differences were observed for prostate, breast, melanoma, colorectal, lung, bladder, and stomach cancers. Disparities in cancer survival have continued to widen, requiring improved understanding and targeted interventions to address inequities.