Researchers from the University of Edinburgh have been exploring mortality rates in patients diagnosed with colorectal cancer in Scotland. Using a dataset that includes everyone diagnosed with colorectal cancer between 2006 and 2018, they have found some surprising results in terms of which characteristics are associated with mortality, beyond the usual characteristics like tumour stage at diagnosis, age and level of disability.

In a new article published in the International Journal of Population Data Science (IJPDS), the research reveals that sex, geographic location and level of deprivation, are also associated with a higher likelihood of death. This may indicate that some individuals diagnosed with colorectal cancer are not getting the care they require, though this requires further investigation.

Colorectal cancer  is the third most common type of cancer in Scotland and the second leading cause of cancer death. Survival from colorectal cancer has been improving over time but survival rates in Scotland still lag behind the rest of the UK and Europe.

The National Health Service (NHS) provides everyone in Scotland with free health care at the point of use. Everyone who needs health care should have access to it without having to pay, including anyone diagnosed with colorectal cancer, so the identification of characteristics such as where someone lives having an effect on mortality, is significant.

The analysis tries to include all characteristics one would expect to affect mortality, to see if there are any differences in the likelihood of dying for patients diagnosed with colorectal cancer, in those factors we would not expect to affect mortality. The unexpected findings that sex, geographic location and socioeconomic status are all associated with higher mortality will now require further investigation to fully understand these differences.

First author Elizabeth Lemmon commented that, “This research only skims the surface on what is an increasingly important area for cancer research and patients diagnosed with cancer in Scotland. By utilising Scotland’s wealth of administrative data, we have been able to analyse treatments and outcomes for colorectal cancer patients diagnosed at an early stage and treated with surgery. Further investigation is required to understand if the differences we observe reflect inherent inequities in care provision or access.”


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Dr Elizabeth Lemmon, Edinburgh Health Economics, University of Edinburgh

Lemmon, E., Hanna, C., Diernberger, K., Paterson, H., Wild, S., Ennis, H. and Hall, P. (2024) “Variation in colorectal cancer treatment and outcomes in Scotland: real world evidence from national linked administrative health data”, International Journal of Population Data Science, 9(1). doi: 10.23889/ijpds.v9i1.2179.