Atlas of Cancer Survivorship in California and the Greater Bay Area

Principal Investigator:
Elizabeth Ellis, Ph.D., Scarlett Lin Gomez, Ph.D.
David Spiegel, M.D., Uri Ladabaum, M.D., Robert Haile Dr.P.H.
Funding Source:
Stanford Cancer Institute
Funding Period:
Study Website:

Cancer is the second most common cause of death in California, but the burden of cancer on the population is not equal. Survival has been shown to differ by sex, marital status, race/ethnicity, and socioeconomic status, but there had been no systematic investigation of disparities in cancer survival in the Greater Bay Area or the state of California. To accurately target cancer control initiatives to patients with the greatest need, it is vital to know not only where disparities in survival occur, but also what is contributing to them. This project aimed to identify disparities in cancer survival in the catchment area served by the Stanford Cancer Institute, and in the state of California, and to inform future initiatives focused on improving outcomes in disadvantaged and under-served populations. We have found considerable socioeconomic and racial/ethnic disparities in survival for all five cancer sites examined, with the largest disparities seen for cancers with a good prognosis (breast, prostate, and melanoma). We found substantial differences in survival by health insurance status that exist across all population groups, and for some cancers these disparities are increasing. We have documented persistent racial/ethnic disparities in cancer survival, and quantified the relative contribution of various factors to these disparities, including tumor, treatment, institutional, sociodemographic and neighborhood characteristics. We have analyzed trends and disparities in colorectal cancer specifically and examined the intersectional relationship between neighborhood socioeconomic status and race/ethnicity.


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