People in lower-income groups have less chance of surviving a cancer diagnosis and experience worse outcomes than their better-off peers, a comprehensive study has found.

Cancer patients on low incomes are 10% less likely to be alive five years after diagnosis. Poorer patients are also more likely to experience stress, financial problems and a worse quality of life as a result of their illness.

The study, by the Netherlands Comprehensive Cancer Organisation (IKNL) said there was no difference in the severity of the disease when it was first diagnosed in lower and higher-income patients, but the outcomes were markedly different.

The gap in survival rates was more acute for men than women, with poorer men 12% less likely to be alive after five years while the difference for women was 7%.

More than one in five people on lower incomes (22%) had financial problems after being diagnosed, compared to 12% of those on higher incomes. Lower earners also found it harder to adapt their working patterns around their treatment.

Adaptable jobs

“Higher earners are more likely to have an office job,” Mieke Aarts, epidemiologist and head researcher at IKNL said. “That makes it easier to work from home or change your hours than if you’re in a factory or working shifts.”

Lower earners were also more likely to have physically demanding jobs that they were unable to keep up with during or after cancer treatment, and fewer alternative options if they had to quit.

Another contributing factor was that less educated patients found it harder to navigate the healthcare system and understand the language used by doctors and oncologists.

“It’s understandable that people panic when they don’t know what doctors mean while they’re seriously ill,” Aarts said. “Under those circumstances it becomes very difficult to take measured decisions about your own life.”

Preventive measures

Earlier research has shown that poorer patients are less likely to receive treatments targeting the tumour and the treatments they are given tend to be less intense.

The researchers said more emphasis should be placed on preventive measures, including deterring people from smoking, which is the main cause of lung cancer, and promoting healthier choices in supermarkets.

The study found that the gap between lower and higher earners was widest in the immediate aftermath of diagnosis and treatment, because they were less able to absorb the shock.

“Lack of money can also be a barrier to being referred to hospital or supportive care such as a physiotherapist,” they wrote.

IKNL said health policy should take into account people’s socio-economic circumstances and ensure all patients had access to the full range of care options, both during and after their treatment.

“We shouldn’t accept that 10% of people live less long with cancer and have a worse quality of life,” Aarts said.