Income Inequality and Colorectal Cancer Survival in Colombia

Colorectal Cancer is a big player in the cancer world, ranking as one of the top causes of illnesses and deaths related to cancer around the globe. Back in 2020, it took the second position as the deadliest cancer and claimed the third spot in terms of how many people were diagnosed. With around 1.9 million new cases and an eye-watering 935,000 deaths every year, it’s clear that this disease is a serious issue. If we look ahead, experts worry that by 2040, the numbers could skyrocket to 3.2 million new cases and 1.6 million deaths each year.

In Colombia, colorectal cancer is particularly concerning. By 2021, it was the third leading cause of cancer cases and deaths, mainly hitting individuals who were 50 years old and above. Many of these individuals are part of the formal workforce, which is important because it shows how this disease affects people who contribute to the economy.

#Formal Workers vs. Healthcare Access

In developing countries like Colombia, people with formal jobs are often seen as better off. They usually have regular paychecks and access to healthcare benefits provided by their employers. However, this doesn’t mean they are free from challenges when it comes to getting proper healthcare, especially for complicated diseases like colorectal cancer. This type of cancer needs quick and specialized care, but factors like healthcare system issues and economic conditions can make things tough—even for those with jobs and health insurance.

Colombia has a health system that aims to cover over 97% of its population, offering what is called contributory and subsidized schemes for healthcare. The goal is to ensure that everyone has fair access to healthcare, no matter their situation. There are also guidelines in place to help doctors diagnose and treat diseases like colorectal cancer in a standardized way. Despite these efforts, studies show that many people in Colombia still face socioeconomic challenges when it comes to early detection, timely treatment, and Survival Rates for cancer. This is puzzling, given that the system is designed to promote fairness in healthcare access.

#Examining Survival Rates Among Formal Employees

Looking into how formal workers with colorectal cancer survive provides a different angle. This group is key to the nation’s productivity, and they should, in theory, face fewer barriers to healthcare than informal workers or those without jobs. However, issues like fragmented care and long waits for specialized treatment are still significant problems that may affect health outcomes.

This study aimed to find out how socioeconomic factors influence three-year survival rates for formal employees diagnosed with colorectal cancer in Colombia from 2012 to 2019. The researchers used monthly minimum wages as a measure of how much money individuals made. Focusing on this group helps shed light on how income impacts health, even when access to healthcare might seem equal.

#Data and Methods

The study involved looking at data from administrative databases to analyze all formal employees in Colombia who were newly diagnosed with colorectal cancer between January 1, 2012, and December 31, 2019. The researchers used specific codes connected to diagnoses and treatment processes to identify the right patients. They defined colorectal cancer as individuals who had at least three diagnostic codes recorded in different months, along with at least one treatment code, like chemotherapy or surgery.

The final group consisted of 1,913 adults who were working at the time of their diagnosis. They were followed for three years after the diagnosis or until death, whichever came first.

To analyze the data, the researchers looked at healthcare usage records, demographic information, and details about patients’ deaths, including when and why these occurred. This helped them gather insights into the population and understand the inequalities in healthcare access and survival outcomes.

#Key Findings on Survival Rates

The results showed that among the 1,913 colorectal cancer patients, 660 people passed away within the three-year follow-up period. This means the three-year mortality rate was about 34.5%. The regions with the highest death rates were Atlántica and Pacífica, where mortality was even higher than the overall proportion for the group.

When survival rates were looked at based on the patients' income (measured by monthly minimum wages), significant differences appeared. Those in the lowest wage bracket had the highest three-year mortality rate, while patients in the highest income bracket enjoyed better survival outcomes. This clearly illustrates a trend: the lower the income, the higher the risk of dying from colorectal cancer.

The risk of death increased noticeably as wages decreased. After adjusting for other factors, those in the highest income quartile had a 25% lower risk of dying compared to those in the lowest quartile. This was a stark reminder that money matters, even when you have a job and insurance.

#A Look at Socioeconomic Inequalities

The study used two specific indices to measure the level of inequality based on income. The Relative Index of Inequality and the Slope Index of Inequality showed that there are distinct differences in cancer survival rates associated with income levels, even after adjusting for other important factors. In simpler terms, these indices confirmed that money plays a big role in how well individuals fare after being diagnosed with colorectal cancer.

#Why Income Matters in Healthcare Access

It's important to recognize that income issues often go hand in hand with other types of inequality. For instance, people with lower incomes may live in areas with limited healthcare options or may have longer wait times for treatments, even when those systems are supposed to provide equal healthcare access. Additionally, the overall quality and consistency of care can vary greatly, influencing survival outcomes.

#Strengths and Limitations of the Study

One of the strong suits of this study was the reliability of the data. It pulled from administrative databases that offered detailed insights into income and employment status, with wage data reported by employers, which tends to be more accurate. The death registry data was also robust and covered over 90% of deaths nationwide.

However, there were some limitations to consider. Because the study relied on databases that used codes for diagnoses and treatments, there was a chance for misclassification of cases. While the data provided a good overview of healthcare usage, it didn't delve deeply into clinical details that could give a more complete picture of the patients’ conditions.

Also, the study focused on a group that is generally in a better position regarding health and income. The differences in survival rates linked to income might be even more dramatic in groups that have less access to employment and healthcare. This means that while the findings were telling, they might not capture the full extent of socioeconomic disparities affecting broader and more vulnerable populations.

#Conclusion: The Road Ahead

In summary, colorectal cancer remains a significant global health issue, and the disparities in survival rates are glaringly clear. Even within a group that is expected to have better access to healthcare, income inequality plays a pivotal role in health outcomes. The findings point out that having a job and insurance does not always guarantee equal access to care or good outcomes. It shows that as long as there are income disparities, health inequalities will persist.

Moving forward, more studies are needed to shed light on how social and economic factors influence health outcomes, especially in populations that face more significant hurdles. Addressing these disparities is essential for ensuring a healthier future for everyone, regardless of their paycheck. After all, we all want to be healthy, and it would be great if our bank accounts didn’t have such a huge impact on that!