Socioeconomic status (SES) has been associated with both cancer incidence and prognosis, with the public health system bearing a large portion of low SES patients. Specific drivers of poorer outcome in patients with low SES have not been fully explained; hampering our ability to act on any inequalities.
The SA population based metastatic colorectal (SA-mCRC) registry was analysed to assess the number of patients treated in public or private hospitals. Patient and treatment characteristics are reported and OS was analysed using Kaplan-Meier method.
Data for 3806 patients in the registry between February 2006 to December 2015 were analysed. 67% were managed in public hospitals. There were no significant differences in median age, gender and site of primary. Public patients had ≥ 3 metastatic sites involved (10.1% vs 6.9%, p<0.003) and received less systemic therapy (ST) (any ST: 55.7% vs 72.7%, p<0.001). 13.1% patients in private hospitals received > 3 (+/- targeted agent) lines of ST compared to 5.6% in the public hospitals (p<0.001). Compared to public patients a higher proportion of patients in private hospitals underwent surgery on the primary and liver (36.3% vs. 44.3% and 12.6% vs. 17.6%; p
Results demonstrate that public patients with mCRC have higher burden of disease, receive less chemotherapy and less likely to have surgical intervention. Survival is subsequently lower for public patients. This may reflect differences in patient populations and the ability to better define why this difference exists highlights the importance of greater recourses for registries to include reporting of important patient characteristics (e.g. comorbidity).