People with high incomes are more likely to be treated for cancer than people with low incomes. RTL News

Patients from low-income groups are less likely to undergo intensive anti-tumor therapy than patients with high income. This is one of the most important conclusions reached by the new study, which focused on five types of cancer, including prostate cancer, melanoma and breast cancer. According to lead researcher Mickey Aarts, this could have all sorts of reasons.

“Part of this can be explained by the fact that people of higher socioeconomic status often have a healthier BMI and, for example, smoke less on average. They also often have less frequent additional conditions and a wider network. But despite this, there are still inexplicable differences.”

There are also hospitals that try to provide the patient with the most appropriate treatment possible, says Arts. “We have not investigated it, but it is possible that people of lower socioeconomic status participate less in such a program. This could also have all kinds of factors.”

In addition, the language spoken between doctor and patient is also important, says general practitioner Christel van Asselt. “Sometimes you see that people, for example, don’t understand the difference between curative treatment, which is supposed to make you completely better, and palliative treatment, where the patient eventually dies. It’s not always easy to express it in understandable language. Explain what the possibilities are.”

Understandable language

The findings are not surprising to Van Asselt. “We know that people with lower incomes have more difficulty getting care. They also often have fewer experts (or even doctors) in their own network, and are less likely to seek a second opinion than people with higher education.”

IKNL offers different recommendations for both doctors and patients to combat negative variations. For example, doctors are asked to focus more on language that the patient understands. And to make it clear that decisions can be made together, in consultation with the oncologist, but also with the general practitioner, for example.

“You can’t choose something unless you know there’s a choice,” says lead researcher Aarts. “Sometimes this isn’t always given enough consideration and patients say to the doctor: ‘Just say the word.’ This can be an excellent choice. But there has to be a choice.” Have a conversation so the doctor knows what’s important to the patient.”

For example, a patient can first talk to their general practitioner, who can help decide what questions to ask, Aarts says. “In this way, the best treatment method can be determined for the patient. But then, you as a patient have to realize that you can do it with your GP. There is often an option, and you don’t have to do it yourself.”

Person-centred care

Another recommendation from the IKNL is to facilitate more person-oriented care. Medical oncologist Janneke Walraven from Radboud UMC is already focusing on this in her work.

“I ask them what kind of job they have, what kind of education they have had or are still having, what kind of social background they have. For example, does someone have to travel far to receive intensive treatment, and it might be difficult for that person to pay for it? Or do you find it difficult to contact your loved ones?

“If the latter is the case, I connect the patient with what is called a case manager who will see what is possible and what is not possible in that specific patient situation. These supervisors are very valuable. We actually have quite a few from many hospitals now working on This is why they are also often involved in more intense conversations (eg when discussing CT scans) and provide additional guidance and a listening ear.

For Godoli Poland of the Pharos Knowledge Center on Health Differences, which works to find solutions to these differences, this research is once again confirmation of what she has been seeing for some time. “Whether it’s in this case with cancer, depression or chronic obstructive pulmonary disease: everywhere you see socioeconomic status influences the incidence of disease and treatment outcomes.”

Poland also agrees with the recommendation to focus more on person-centered care. “One patient simply needs more support and guidance than another. Care pathways are still often designed for the same treatment for everyone, but in practice this works better for one patient than another. For people of lower social class – “The economic situation, the current systems may not work well.”

“Much to be gained”

Despite the recommendations of the study, which is part of a trio of studies on socioeconomic differences surrounding cancer, reducing those differences is a long shot, lead researcher Aarts believes.

“There are so many opportunities to take all kinds of small steps now,” she says. “For example, the feedback method is very good: as a doctor, you have told everything in the treatment room and then you can ask the patient if they can repeat it in their own words. There are more small steps that we can actually take. But the deeper reasons really require Longer breath.”