We are not all the same when it comes to cancer: the postal code affects more than the genetic code

Once it attacks, cancer does it equally, but we are not all the same when it comes to cancer. This is the conclusion of the report published by the Spanish Association Against Cancer on the world day against this disease.

And it is that the inequality is evident in three main axesbased on the community you live in, based on your bank account and the research resources devoted to each type of cancer.

The informative expert Deborah García explains it. “Getting sick is not free. To begin with, because a cancer diagnosis brings with it a labor and economic impact. 16% of patients admit to being more economically dependent after diagnosis, a figure that rises to 20% when it comes to people lower class 16.5% of cancer patients paid more than 10,000 euros in direct expenses derived from the disease: medical expenses, transportation and diets, care for dependent people… And to this we must add the opportunity cost that means the loss of income due to being in active cancer treatment”, he points out.

The socioeconomic level is a factor of inequality in cancer and especially affects patients who are unemployed, self-employed or earn less than the Minimum Interprofessional Wage, a situation experienced by twice as many women as men.

From the cancer type perspectivein Spain every year 100,000 people are diagnosed with tumors whose survival is low or stagnant, so they do not have the same opportunities to overcome cancer.

3 out of 10 patients do not receive the radiotherapy they should

“In some Spanish provinces there is a lack of radiotherapy units, which forces patients to travel for several hours to receive their treatment. Access to cancer detection programs is also unequal depending on the autonomous community. And 30% of patients who should receive radiotherapy do not receive it. There should be seven or eight accelerators per million inhabitants and in Spain there are 5.2 if the public and private network is taken into account,” García points out.

Also inequalities that have to do with the access to healthy environments, early diagnosis, treatments such as psychological care and palliative care and research. Studies indicate that about 50% of patients have emotional distress and 30% need specialized psychological care, like many families. On the other hand, 48% of the hospitals do not have their own personnel to carry out psychological care in cancer and in 52% of the cases there is, but it is insufficient.

Today, seven communities have not managed to ensure that their entire population at risk (50 to 69 years old) has access to a colorectal screening programme, and more than a third still do not act to regulate smoke-free spaces, to which almost half of children under 12 are exposed. Madrid, Castilla-La Mancha, Castilla y León, Aragón, Navarra and Cantabria have not promoted initiatives in this line despite the fact that tobacco is responsible for up to 33% of cancers worldwide, and up to 22% of deaths .

About palliative careSpain is at the bottom of the recommended ratios with 0.6 units per 100,000 inhabitants, when for adequate care 2 units are needed per 100,000 inhabitants, one home and one hospital. Patients in La Rioja and the Canary Islands bear the brunt: below 0.32 and 0.40 units. For the association, research is key to increasing survival because promoting it and guaranteeing patient access to results is a priority for the Association, which aims to achieve an average survival rate of 70% by 2030.

Early detection has slowed down in recent years

The association estimates the number of new cases of cancer diagnosed in Spain in 2021 at 285,530. This means that for every 100,000 people residing in Spain, more than 600 have suffered from cancer in 2021 alone. The calculation indicates that 109,589 people died from cancer in Spain in the year 2021. The crude mortality rate was 231 cancer deaths per 100,000 population.

According to the report, an estimated 48,508 people diagnosed with cancer each year live alone. Added to them are 69,032 new diagnoses in couples over 65 years of age. In recent decades, the absolute number of cancers diagnosed in Spain has grown as a result of the aging of the population, exposure to risk factors and the increase in early detection, which, however, has slowed down in recent years, partly due to the pandemic.