Galilee Medical Center and Medical Faculty find differences in cancer survival depending on socioeconomic status

Even though Israel has a universal health insurance system in which all residents are entitled to a basic basket of free medical care and subsidized medications, there are still gaps among various sectors in the population on the quality and accessibility of care. 


A large-scale study published in the Head and Neck – the leading medical journal in head and neck cancer – found that the survival rate of patients who contracted this type of malignancy and lived in areas of the country with a lower socioeconomic level is significantly lower than the survival rate of patients with a higher socioeconomic background. This is significant research, as numerous Israelis are diagnosed with head and neck cancer in an average year, and too many of them die of it. 


The study, entitled “Effect of socioeconomic status on survival in patients with head and neck cancer,” was conducted as part of a final thesis by Dr. Baruch Weizman, a new graduate of the Azrieli Faculty of Medicine in Bar-Ilan University in Ramat Gan (near Tel Aviv), who worked under Dr. Ohad Ronen, director of the head and neck surgery unit in the otolaryngology department at the Galilee Medical Center in Safed. 


The researchers analyzed data on some 12,000 people who were diagnosed with this malignancy between 2000 and 2017. The information was collected anonymously, with the assistance of Dr. Barbara Silverman from the Israel National Cancer Registry. The mean age was 64, and about one-third of patients were women. the most common tumor. The most common site was the oral cavity followed by the larynx (the voice box). 


They found that the socioeconomic area in which patients live has a significant impact on their chances of survival. Patients from high socioeconomic areas had better overall five-year survival than patients from low socioeconomic areas,


The median survival of patients belonging to high socioeconomic status was 18 months longer than the survival of patients of low socioeconomic status. These findings are consistent with the findings of previous studies that showed a link between living in the periphery of Israel and a higher risk of developing all types of cancer. The study contributed to knowledge in the field of this malignancy that was unknown before.


In this large-scale study, an assessment was also made of the effect of additional factors on the chances of recovery. It was found that among Israelis aged 65 and older at the time of diagnosis, there was a negative effect on survival if they lived farther from the center of the country. 


The researchers speculate that there are gaps in the level and availability of public medicine in Israel among populations from different socioeconomic backgrounds and in the periphery. The authors encouraged decisionmakers to invest more resources, improve medical infrastructure and encourage physicians to work in disadvantaged socio-economic areas. They further point out that medical information should be improved in these areas.


Additional factors, such as the tendency among the less-educated and those with lower income to smoke may influence the difference in survival. In addition, people who live on the coast of Haifa, where residents are more exposed to carcinogens from oil refineries and other factories, and those living near garbage dumps in the south may also cause the higher mortality rate, although the researchers said involvement of such environmental factors in head and neck cancer had not been proven. 



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