Social and geographic predictors of cancer survival : A role of population-based cancer registry in cancer control

Teerapon Muangpaisan, D. of Internal Medicine, F. of Medicine, PSU.
Hutcha Sriplung, Assoc. Prof., D. of Pathology, F. of Medicine, PSU.
Corresponding e-mail : shutcha@ratree.psu.ac.th

Published : Asian Pacific J Cancer Prev 2000, 1(4) : 319-323
Key words : social factor, geography, predictors of cancer survival, cancer registry, cancer control

One of the objectives of cancer registry is to provide survival information in subsections of the population that have unfavorable outcomes, A cancer control strategy can be planned on that information. This study analyzed the data of Songkhla Cancer Registry to determine if social and geographic parameters can be used to predict cancer survival. Cases were identified in the popula- tion-based cancer registry of Songkhla Province registered during 1990-1994. A total of 3423 cases were used in this study. The rest were excluded because of unknown primary cancer sites. Eight leading primary cancer sites were focused : oral cavity, pharynx, esophagus, colorectum, lung, liver, breast, and cervix uteri. Predictors of survival were derived from items recorded in the registry. Age, gender, extent of disease, cultural belief, life-style, and accessibility to medical care were the predic- tors of interest. Religion, urban environment, and distance to tertiary care centers were the proxies of the last three parameters. Kaplan-Meier plot, Cox regression, and log-rank tests were used in analy- sis of the hazard ratio. The results revealed the significance of disease extent in the survival from oral, colorectal, breast, and cervical cancers. Muslim people had a poorer survival rate than that of Buddhists in oral, breast, and cervical cancers. Women with breast cancer living in distant area from tertiary medical care centers had poorer prognosis. In the non-aggressive cancers, prolonged survival by early detection and pretreatment counseling for the prevention of unnecessary incomplete treat- ment is recommended. In aggressive cancers such as lung, liver, and pharyngeal cancers, there was no significant difference by these parameters. Good quality of life provided by palliative care, not the prolong survival, is the ultimate goal in medical care services to these patients.
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