Cancer patients with a lower socioeconomic status or who live in the periphery are more likely to die faster from certain cancers, a new study has shown.
In a paper published in the peer-reviewed Head & Neck journal, doctors from Galilee Medical Center and the Azrieli School of Medicine at Bar-Ilan University in Safed show that there is a 15% to 20% difference in the five-year survival rate between patients living in the periphery versus the center, and between patients with higher socioeconomic status versus lower – meaning that poorer people living in Israel’s North or South could live an average of a year-and-a-half less than their richer and more centrally located peers.
The research, led by doctors Baruch Weizman, Ohad Ronen and Nili Golan – with the help of data provided by Dr. Barbara Silverman of the Israel National Cancer Registry – examined patients suffering from head and neck cancer. It looked at 12,000 people who were diagnosed between 2000 and 2017.
Head and neck cancer is the seventh most common cancer in the world, with about 850,000 cases and 450,000 deaths per year.
Socioeconomic class was defined according to the Central Bureau of Statistics assessment index.
The study’s findings, according to Weizman, were consistent with the findings of previous smaller studies that showed a link between living in Israel’s periphery and a higher risk of developing all types of cancer.
He said that the researchers have speculated as to why there is such a striking difference and believe it is tied to several factors: level of availability of public medicine and medical infrastructure, as well as culture and education.
Weizman said, for example, that many immigrant groups live in the North and South, and may struggle with the language.
Moreover, Ronen told The Jerusalem Post that there are less doctors in the periphery than in other parts of the country and a lower number of imaging and other necessary equipment for the doctors to use in diagnosing sick patients.
“There are a lower number of CT and MRI machines, less accessibility to oncology departments, longer waits that mean it takes more time to make a diagnosis and less available operating rooms so it takes more time to schedule surgery,” Ronen, who works in Nahariya but used to work in Haifa, said. “You have the same doctors and nurses – the same man-quality – but less of them.
“We think the Health Ministry should divert more budget to the periphery so these patients can have the same chance of surviving disease as people in the center of Israel,” he said.
This is the first study done on such a large scale in Israel. The report indicated that beyond investment, next steps would include evaluating other factors, such as tumor staging, smoking status and quality of treatment, as well as exploring the delivery of timely care in the periphery compared to in the center.