Socioeconomic Inequalities in Colorectal Cancer Survival in Southern Spain: A Multilevel Population-Based Cohort Study

Figures & data

Table 1 Vital Status at 10 Years, Age, Sex, and TNM Cancer Stage at Cancer Diagnosis Among Colorectal Cancer Patients in Granada, Between 2011 and 2013, n = 3,589

Variables		n (%)
Vital status at 10 years
	Alive	2,617 (73.1)
	Dead	964 (26.9)
Age at diagnosis, years
	<50	265 (7.4)
	50–59	529 (14.7)
	60–69	953 (26.5)
	70–75	695 (19.4)
	>75	1,147(32.0)
Sex
	Male	2,112 (58.9)
	Female	1,477 (41.1)
TNM stage at diagnosis
	I	641 (17.9)
	II	1,107 (30.8)
	III	1,082 (30.1)
	IV	574 (16.0)
	Missing	185 (5.1)

Table 2 Ten-Year Overall Mortality Rate and Mortality Rate Ratios by Sociodemographic Characteristics, TNM Cancer Stage at Diagnosis, and Quintiles of Deprivation Among Colorectal Cancer Patients in Granada, Between 2011 and 2013, n = 3,589

Variables	Deaths/Pyr	Mortality Rate per 1000 pyr (95% CI)	Mortality Rate Ratio (95% CI)	p-value
Sex				<0.001
Male	602/6,878	87.5 (80.8–94.8)	Ref.
Female	362/5,270	68.7 (62.0–76.1)	0.8 (0.7–0.9)
Age at diagnosis, years				<0.001*
<50	40/1,024	39.1 (28.7–53.3)	Ref.
50–59	74/1,997	37.0 (29.5–46.5)	0.9 (0.6–1.4)
60–69	163/3,609	45.2 (38.7–52.7)	1.2 (0.8–1.6)
70–75	186/2,631	70.7 (61.2–81.6)	1.8 (1.3–2.5)
>75	501/2,886	173.6 (159.0–189.5)	4.4 (3.2–6.1)
TNM stage at diagnosis				<0.001*
I	96/2,529	38.0 (31.1–46.4)	Ref.
II	215/4,215	51.0 (44.6–58.3)	1.3 (1.1–1.7)
III	238/3,867	61.5 (54.2–69.9)	1.6 (1.3–2.1)
IV	331/995	332.7 (298.6–370.3)	8.6 (7.0–11.0)
Quintiles of deprivation				<0.001*
Q1 (less deprived)	178/2,569	69.3 (59.8–80.2)	Ref.
Q2	175/2,484	70.5 (60.7–81.7)	1.0 (0.8–1.2)
Q3	198/2,458	80.6 (70.1–92.6)	1.2 (0.9–1.4)
Q4	204/2,465	82.8 (72.1–94.9)	1.2 (1.0–1.5)
Q5 (most deprived)	209/2,172	96.2 (84.0–110.2)	1.4 (1.1–1.7)

Note: *Test for trend p-value.

Abbreviations: pyr, person-years; CI, confidence interval.

Table 3 Excess Mortality Risk by Deprivation Quintiles Adjusted for Sex, Age, TNM Cancer Stage at Diagnosis, and Census Tract Area in Granada, Between 2011 and 2013, n = 3,404

Variables	Model 1 EMRR (95% CI)	Model 2 EMRR (95% CI)	Model 3 EMRR (95% CI)	Model 4 EMRR (95% CI)	Model 5 EMRR (95% CI)
Quintiles of deprivation
Q1	Ref.	Ref.	Ref.	Ref.	Ref.
Q2	1.0 (0.7–1.4)	1.0 (0.7–1.4)	0.9 (0.7–1.3)	0.8 (0.8–1.5)	1.2 (0.8–1.8)
Q3	1.2 (0.9–1.7)	1.2 (0.9–1.7)	1.2 (0.9–1.6)	1.4 (1.0–1.8)	1.5 (1.0–2.1)
Q4	1.1 (0.8–1.6)	1.2 (0.8–1.5)	1.1 (0.8–1.6)	1.3 (0.9–1.7)	1.4 (1.0–2.0)
Q5	1.6 (1.2–2.1)	1.6 (1.2–2.1)	1.4 (1.1–1.9)	1.5 (1.1–2.0)	1.6 (1.1–2.3)
Sex
Female		Ref.	Ref.	Ref.	Ref.
Male		1.2 (1.0–1.4)	1.2 (1.0–1.4)	1.1 (0.9–1.4)	1.2 (1.0–1.5)
Age at diagnosis
<50			Ref.	Ref.	Ref.
50–59			0.8 (0.5–1.3)	1.1 (0.7–1.7)	1.2 (0.7–1.8)
60–69			0.9 (0.6–1.3)	1.0 (0.7–1.5)	1.2 (0.7–1.8)
70–75			1.1 (0.7–3.6)	1.4 (0.8–2.0)	1.5 (0.9–2.3)
>75			2.5 (1.8–3.6)	3.1 (2.1–4.4)	4.0 (2.7–6.1)
TNM stage at diagnosis
I				Ref.	Ref.
II				2.8 (1.1–7.1)	2.4 (1.0–6.0)
III				4.5 (1.7–11.60)	4.4 (1.8–10.4)
IV				32.7 (13.5–79.7)	44.7 (18.9–105.9)
Census tracts
Variance (95% CI)					0.78 (0.55, 1.11)

Notes: Model 1: univariate excess mortality by quintiles of deprivation. Model 2: bivariate excess mortality by deprivation adjusted for sex. Model 3: multivariate excess mortality by deprivation adjusted for sex and age at diagnosis in categories. Model 4: multivariate excess mortality by deprivation adjusted for sex, age and cancer TNM stage. Model 5: multilevel multivariate excess mortality by deprivation adjusted for sex, age and cancer TNM stage accounting for the census tract level area.

Abbreviations: EMRR, excess mortality risk ratio; CI, confidence interval.

Figure 1 Relative survival probability, restricted mean survival time, and restricted mean survival time differences in years by levels of deprivation (Q5 vs Q1) among colorectal cancer patients in Granada, between 2011–2013, n = 3582.

Notes: (A) Relative survival probability by the quintiles of deprivation. Solid line: Q5 and dashed line: Q1. (B) Restricted mean survival time in years by the quintiles of deprivation. Solid line: Q5 and dashed line: Q1. (C) Restricted mean survival time differences in years by the quintiles of deprivation (Q5 vs Q1). Solid line: differences, grey shaded area: 95% CI.

Figure 2 Sex-specific relative survival probability by deprivation (Q5 vs Q1) and age at cancer diagnosis among colorectal cancer patients in Granada, between 2011–2013, n = 3,582.