Cancer is one of the leading causes of mortality and morbidity worldwide, but particularly in high-income countries. Nevertheless, medium and low-income countries have been undergoing an epidemiological transition, with falling mortality from transmissible diseases and increased mortality from non-communicable diseases, such as cancer.
As such, improving cancer-related outcomes is paramount to improving the world population life expectancy and quality of life. While scientific and technological breakthroughs have allowed substantive improvements in cancer-related outcomes, marked inequalities exist between countries. Furthermore, inequalities in cancer-related outcomes are also observed within countries or populations. While unfortunately inevitable, inequalities are unfair, and it has been acknowledged that tackling them is essential to achieve equity and improve society's overall health outcomes.
Cancer incidence and its related outcomes are shaped by the interplay between several factors in the cancer continuum. Inequalities exist at all stages of the cancer care continuum, from prevention to survivorship and palliative care. While public interventions have been devised to improve cancer-related outcomes, how they impact inequalities is often understudied.
This thesis includes a collection of research articles that evaluate the equity impact of measures to reduce tobacco smoking and alcohol consumption and improve mammography uptake in Geneva, Switzerland. In addition, one study is presented on how a key feature of the Swiss health care system (different health insurance deductibles) is associated with forgoing health care.
Together, these research works aim to inform decision-makers, medical professionals, researchers, patients and the general public of the current equity gaps in some cancer-related outcomes and how public health interventions impact them.