Impact of cancer diagnosis on life expectancy by area-level socioeconomic groups in New South Wales, Australia - a population-based study

Sep 21, 2026

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Improvement in cancer survival has not reduced socioeconomic disparities, and cancer diagnosis still leads to unequal outcomes across communities. This population-based study quantifies the loss of life expectancy (LOLE) attributable to a cancer diagnosis and assesses how LOLE differs by area-level socioeconomic status (SES). Data include all individuals aged 50–89 diagnosed in New South Wales between 2001 and 2019 with mortality follow-up through December 2020, using flexible parametric survival models for 12 common cancers.

LanguageEnglish

CategoryResearch & Report

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Abstract

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Cancer Biol Med 2024. doi: 10.20892/j.issn.2095-3941.2024.0166 ORIGINAL ARTICLE Impact of cancer diagnosis on life expectancy by area-level socioeconomic groups in New South Wales, Australia: a population-based study Md Mijanur Rahman1, Michael David1,2, David Goldsbury1, Karen Canfell1, Kou Kou3, Paramita Dasgupta3, Peter Baade3*, Xue Qin Yu1* 1The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, NSW 1340, Australia; 2School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4222, Australia; 3Cancer Council Queensland, Brisbane, QLD 4006, Australia | ABSTRACT | Objective: Improvement in cancer survival over recent decades has not been accompanied by a narrowing of socioeconomic disparities. This study aimed to quantify the loss of life expectancy (LOLE) resulting from a cancer diagnosis and examine disparities in LOLE based on area-level socioeconomic status (SES) .
Methods: Data were collected for all people between 50 and 89 years of age who were diagnosed with cancer, registered in the NSW Cancer Registry between 2001 and 2019, and underwent mortality follow-up evaluations until December 2020. Flexible parametric survival models were fitted to estimate the LOLE by gender and area-level SES for 12 common cancers.
Results: Of 422,680 people with cancer, 24% and 18% lived in the most and least disadvantaged areas, respectively. Patients from the most disadvantaged areas had a significantly greater average LOLE than patients from the least disadvantaged areas for cancers with high survival rates, including prostate [2.9 years (95% CI: 2.5–3.2 years) vs. 1.6 years (95% CI: 1.3–1.9 years)] and breast cancer [1.6 | | --- | --- | | KEYWORDS | years (95% CI: 1.4–1.8 years) vs. 1.2 years (95% CI: 1.0–1.4 years)]. The highest average LOLE occurred in males residing in the most disadvantaged areas with pancreatic [16.5 years (95% CI: 16.1–16.8 years) vs. 16.2 years (95% CI: 15.7–16.7 years)] and liver cancer [15.5 years (95% CI: 15.0–16.0 years) vs. 14.7 years (95% CI: 14.0–15.5 years)]. Females residing in the least disadvantaged areas with thyroid cancer [0.9 years (95% CI: 0.4–1.4 years) vs. 0.6 years (95% CI: 0.2–1.0 years)] or melanoma [0.9 years (95% CI: 0.8–1.1 years) vs. 0.7 years (95% CI: 0.5–0.8 years)] had the lowest average LOLE.
Conclusions: Patients from the most disadvantaged areas had the highest LOLE with SES-based differences greatest for patients diagnosed with cancer at an early stage or cancers with higher survival rates, suggesting the need to prioritise early detection and reduce treatment-related barriers and survivorship challenges to improve life expectancy.
Cancer diagnosis; life expectancy; loss of life expectancy; area-level socioeconomic status; flexible parametric model | Introduction People diagnosed with cancer are living longer than ever before and the number of cancer survivors is growing rapidly worldwide. Despite consistent improvement in survival for many cancer types over recent decades, disparities by area-level socioeconomic status (SES) persist in many countries, including *Joint senior author. Correspondence to: Md Mijanur Rahman [E-mail: m. m.rahman@sydney.edu.au](E-mail: m. m.rahman@sydney.edu.au) ORCID ID: [https://orcid.org/0000-0001-6879-2049](https://orcid.org/0000-0001-6879-2049) Received May 7, 2024; accepted June 10, 2024; published online July 22, 2024. Available [at www.cancerbiomed.org](at www.cancerbiomed.org) ©2024 The Authors. Creative Commons Attribution-NonCommercial 4.0 International License Australia1-3. A substantial body of research has demonstrated socioeconomic and residence in remote area disparities in cancer survival4-7. While the reasons for these disparities are multi-faceted, some of the differences may stem from a more advanced stage of diagnosis and sub-optimal treatment options for patients in the most disadvantaged areas8. Quantifying the disparities in years

FAQs

What is the main purpose of the study?

The study aims to quantify the loss of life expectancy (LOLE) caused by a cancer diagnosis and examine differences in LOLE across area-level socioeconomic status (SES) groups in New South Wales.

How were participants selected and followed up?

Participants were people aged 50 to 89 diagnosed with cancer and registered in the NSW Cancer Registry between 2001 and 2019, with mortality follow-up assessments conducted until December 2020.

Which groups experienced higher loss of life expectancy?

Patients from the most disadvantaged areas showed higher average LOLE than those from the least disadvantaged areas for several high-survival cancers, and the study reports the largest average LOLE in specific sex and cancer combinations.

Sep 21, 2026

Uploaded by Asher