Erin Strumpf, McGill University - Real-World Evidence on Social Inequalities in Cancer Care and Outcomes

Title: Real-World Evidence on Social Inequalities in Cancer Care and Outcomes: New Canadian Data Resources and Potential Cross-Country Collaborations

Abstract: Canadian health care systems boast universal insurance coverage and no parallel private insurance coverage that could create “two-tier” health care. Until recently, evidence of social inequalities in cancer care and outcomes has been relatively limited, which many have interpreted as a good-news story. New data resources that link cancer registry and health care data to individual-level measures of socioeconomic position (rather than area-level measures) provide a more nuanced picture. We use rich data linked in Statistics Canada’s secure data environment to document inequalities among patients with lung and colorectal cancers by characteristics including income, education, and immigration status. We also consider the role of these individual characteristics in the context of the unequal distribution of health care resources according to geographic region and along the urban-rural spectrum. We examine misclassification between household- and neighborhood-level income measures, estimate inequalities in the length and structure of the diagnostic interval by income, and estimate socioeconomic inequalities in survival, including stage at diagnosis as a potential mediating factor. I will reflect on how such analyses could contribute to better and more equitable care across the cancer continuum in Canada. I hope you will join me in a discussion of how international collaborations using similar data could stimulate improvements in cancer care in health care systems around the world.

Presenter: Erin Strumpf, McGill University

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