Restoring confidence in public statements by independently testing and verifying the facts
Is your income the most reliable predictor of whether you will die from cancer?
By James Lane and Louise Evans
“The most reliable predictor of whether or not you will die from cancer is not actually your general health, it is not even your family history. It is your income.”
Labor leader Bill Shorten. May 5, 2019.
Labor announced a $2.3 billion Medicare Cancer Plan to fund six million free scans and tests and three million free specialist appointments over four years to reduce out-of-pocket treatment costs for cancer sufferers. 
AAP FactCheck examined the claim by Labor leader Bill Shorten that the most reliable predictor of cancer survival is not a patient’s general health or family history but income.
AAP FactCheck asked Mr Shorten’s office for the source of his claim but received no reply.
In 2017 cancer accounted for 28.1 per cent of deaths in Australia, or around 45,200 people, according to the Australian Bureau of Statistics (ABS). In 2017-18 around one in 50 (1.8 per cent or 432,400) Australians had cancer. 
A 2019 Australian Institute of Health and Welfare (AIHW) cancer report found between 2010 and 2014 the age-standardised mortality rate for all cancers was highest among patients in the lowest socioeconomic group and lowest among those from the highest socioeconomic group.
The five-year cancer survival rate was 67 per cent for those living in the most socioeconomic advantaged areas, while the lowest socioeconomic areas recorded a rate of 55 per cent, the (AIHW) report found.
Between 2012 and 2016, the mortality rate for all cancers combined was 187 deaths per 100,000 people in the lowest socioeconomic areas and 136 per 100,000 in the highest socioeconomic areas. 
A Cancer Council of Australia’s submission to the National Health and Medical Research Council stated “the available evidence on cancer and socioeconomic status clearly shows that people in disadvantaged groups have markedly higher cancer mortality rates, largely attributable to reduced access to health promotion information and consequent higher risk behaviours”. 
Associate Professor Brigid Lynch, a senior research fellow at Cancer Council Victoria stated in 2017 it was very clear a person’s socioeconomic position had a strong influence on cancer incidence and mortality in Australia.
“The better off people are, the less likely they are to develop most cancers - and they are more likely to survive after diagnosis,” Professor Lynch said. “We know that socioeconomic position influences cancer in a number of ways including via health behaviours.” 
These Australian findings were supported by a 2018 US study led by doctors Jeremy O’Connor and Cary Gross from the Yale University School of Medicine, which found people in low and middle-income US counties were more likely to die of cancer than those in high-income counties.
The US study found eight factors, including lack of access to high-quality clinical care, food insecurity, smoking and obesity may help explain more than 80 per cent of the relationship between poverty and disparities in cancer death rates.  
AAP FactCheck concludes that based on this evidence in Australia and the US, Mr Shorten’s claim is mostly true. Income has a “strong influence” on a patient’s chances of dying from cancer but it is not necessarily the “most reliable” predictor as he stated.
- Mostly True - Mostly accurate, but there is one minor error or problem.
1. ‘Paul Keating rallies Labor faithful with attack on outdated Liberals - as it happened’, by Amy Remeikis. The Guardian. May 5, 2019: https://www.theguardian.com/australia-news/live/2019/may/05/federal-election-2019-labor-launch-coalition-sunday-politics-live?page=with:block-5cce53ad8f086f179813b5b0
2. ‘4364.0.55.001 - National Health Survey: First Results, 2017-18. Cancer’. ABS. December 12, 2018: https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.001~2017-18~Main%20Features~Cancer~40
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5. ‘We mapped cancer rates across Australia'. The Conversation. September 14, 2018: https://theconversation.com/interactive-we-mapped-cancer-rates-across-australia-search-for-your-postcode-here-102256
6. ‘Eight Factors May Link Disparities in Cancer Death Rates and Income.’ National Cancer Institute. November 8, 2018: https://www.cancer.gov/news-events/cancer-currents-blog/2018/factors-linking-cancer-death-income-disparities
7. ‘Factors Associated With Cancer Disparities Among Low-, Medium-, and High-Income US Counties’, by Jeremy O’Connor, Tannaz Sedghi and Meera Dhodapkar. Jama Network Open. October 5, 2018: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2705856
- First published May 7, 2019 15:21 AEST