OP81 Socioeconomic inequalities in trends in childhood cancer survival in England 2002–2019: population based study

Background

Childhood cancer survival figures have improved between 2002 and 2019. However, these overall figures may mask differences in survival for children living in different socioeconomic conditions as seen in adult cancer survival.

Methods

We estimated 5- and 10-year survival figures for children diagnosed with cancer between 2002 and 2019 using data from the National Cancer Registration and Analysis Service. Where full follow-up information was available survival was estimated using the cohort approach; where full follow-up was not available estimates of survival used the period approach, which assumes that people will experience the most recently observed conditional probabilities of survival in each year up to 5 or 10 years since diagnosis. Survival estimates were stratified based on an area based measure of deprivation in which postcode of residence was mapped to quintiles of the Index of Multiple Deprivation (IMD). All estimates are age-standardised using equal weights for each of the 5-year age groups (0–4, 5–9 and 10–14years). Locally weighted regression smoothing was applied to highlight trends over time.

Results

Consistently lower 5- and 10- year survival estimates were seen for children diagnosed with cancer living in the most deprived quintile compared with those living in the least deprived quintile. 5-year survival was between 0.4 and 5.8 percentage points lower, and 10-year survival between 0.1 and 7.9 percentage points lower, in children living in the most deprived quintile compared with those living in the least deprived quintile. The most pronounced differences in trends in survival estimates were seen for 10-year survival which showed a sharp divergence for children diagnosed with cancer between 2008–2011 dependent on their deprivation quintile. Children living in the least deprived quintile showed an increase in 10-year survival from 75.5% in children diagnosed in 2002 to 82.9% in those diagnosed in 2010, and a marginal increase to 83.8% in those diagnosed in 2019. In contrast, children living in the most deprived quintile showed an increase in survival from 72.7% to 79.1% for those diagnosed in 2002 to those diagnosed in 2007, followed by a decrease to a low of 75.3% for those diagnosed in 2011, with survival estimates only reaching 2007 levels again for those diagnosed in 2019 (79.3%).

Conclusion

Stark inequalities in both 5- and 10-year survival appeared for children diagnosed around 2008–2011 with children living in the most deprived quintiles having lower survival estimates than those living in the least deprived quintiles. Inequalities in survival estimates were seen throughout the 2010s.