An international comparison of cancer survival: metropolitan Toronto, Ontario, and Honolulu, Hawaii.
Am J Public Health
; 90(12): 1866-72, 2000 Dec.
Article
en En
| MEDLINE
| ID: mdl-11111258
ABSTRACT
OBJECTIVES:
Comparisons of cancer survival in Canadian and US metropolitan areas have shown consistent Canadian advantages. This study tests a health insurance hypothesis by comparing cancer survival in Toronto, Ontario, and Honolulu, Hawaii.METHODS:
Ontario and Hawaii registries provided a total of 9190 and 2895 cancer cases (breast and prostate, 1986-1990, followed until 1996). Socioeconomic data for each person's residence at the time of diagnosis were taken from population censuses.RESULTS:
Socioeconomic status and cancer survival were directly associated in the US cohort, but not in the Canadian cohort. Compared with similar patients in Honolulu, residents of low-income areas in Toronto experienced 5-year survival advantages for breast and prostate cancer. In support of the health insurance hypothesis, between-country differences were smaller than those observed with other state samples and the Canadian advantage was larger among younger women.CONCLUSIONS:
Hawaii seems to provide better cancer care than many other states, but patients in Toronto still enjoy a significant survival advantage. Although Hawaii's employer-mandated health insurance coverage seems an effective step toward providing equitable health care, even better care could be expected with a universally accessible, single-payer system.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Neoplasias de la Próstata
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Calidad de la Atención de Salud
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Neoplasias de la Mama
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Salud Urbana
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Cobertura del Seguro
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Seguro de Salud
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Am J Public Health
Año:
2000
Tipo del documento:
Article
País de afiliación:
Canadá