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dc.contributor.authorBaade, PD
dc.contributor.authorTurrell, G
dc.contributor.authorAitken, JF
dc.date.accessioned2021-02-04T02:09:52Z
dc.date.available2021-02-04T02:09:52Z
dc.date.issued2010-01-28
dc.identifierpii: 1471-2407-10-24
dc.identifier.citationBaade, P. D., Turrell, G. & Aitken, J. F. (2010). A multilevel study of the determinants of area-level inequalities in colorectal cancer survival.. BMC Cancer, 10 (1), pp.24-. https://doi.org/10.1186/1471-2407-10-24.
dc.identifier.issn1471-2407
dc.identifier.urihttp://hdl.handle.net/11343/259593
dc.description.abstractBACKGROUND: In Australia, associations between geographic remoteness, socioeconomic disadvantage, and colorectal cancer (CRC) survival show that survival rates are lowest among residents of geographically remote regions and those living in disadvantaged areas. At present we know very little about the reasons for these inequalities, hence our capacity to intervene to reduce the inequalities is limited. METHODS/DESIGN: This study, the first of its type in Australia, examines the association between CRC survival and key area- and individual-level factors. Specifically, we will use a multilevel framework to investigate the possible determinants of area- and individual-level inequalities in CRC survival and quantify the relative contribution of geographic remoteness, socioeconomic and demographic factors, disease stage, and access to diagnostic and treatment services, to these inequalities. The multilevel analysis will be based on survival data relating to people diagnosed with CRC in Queensland between 1996 and 2005 (n = 22,723) from the Queensland Cancer Registry (QCR), area-level data from other data custodians such as the Australian Bureau of Statistics, and individual-level data from the QCR (including extracting stage from pathology records) and Queensland Hospitals. For a subset of this period (2003 and 2004) we will utilise more detailed, individual-level data (n = 1,966) covering a greater range of risk factors from a concurrent research study. Geo-coding and spatial technology will be used to calculate road travel distances from patients' residence to treatment centres. The analyses will be conducted using a multilevel Cox proportional hazards model with Level 1 comprising individual-level factors (e.g. occupation) and level 2 area-level indicators of remoteness and area socioeconomic disadvantage. DISCUSSION: This study focuses on the health inequalities for rural and disadvantaged populations that have often been documented but poorly understood, hence limiting our capacity to intervene. This study utilises and develops emerging statistical and spatial technologies that can then be applied to other cancers and health outcomes. The findings of this study will have direct implications for the targeting and resourcing of cancer control programs designed to reduce the burden of colorectal cancer, and for the provision of diagnostic and treatment services.
dc.languageeng
dc.publisherSpringer Science and Business Media LLC
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titleA multilevel study of the determinants of area-level inequalities in colorectal cancer survival.
dc.typeJournal Article
dc.identifier.doi10.1186/1471-2407-10-24
melbourne.affiliation.departmentMedicine Dentistry & Health Sciences
melbourne.affiliation.facultyMedicine, Dentistry & Health Sciences
melbourne.source.titleBMC Cancer
melbourne.source.volume10
melbourne.source.issue1
melbourne.source.pages24-
dc.rights.licenseCC BY
melbourne.elementsid1218314
melbourne.openaccess.pmchttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2837617
melbourne.contributor.authorTurrell, Gavin
dc.identifier.eissn1471-2407
melbourne.accessrightsOpen Access


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