The influence of socioeconomic status on the use of preoperative radiotherapy in rectal cancer was evaluated in this study, which linked individually attained data on civil status, education and income to the Swedish Rectal Cancer Registry 1995–2005 (n=16,713). Preoperative radiotherapy was given to 46% of the patients; the crude rate varied with age, gender, civil status, education and income as well as with sublocalisation, stage, type of hospital and health care region. Multivariate analysis revealed inequalities in use of preoperative radiotherapy by civil status: all civil status groups were less likely than married patients to have preoperative radiotherapy; the OR for unmarried patients was 0.67. The use of PRT was also linked to income; the OR for patients with income Q1 versus Q4 was 0.76. The inequalities by civil status and income remained unchanged in groups with a relatively stronger indication for adjuvant radiotherapy, i.e. younger patients and in low rectal cancer. Use of preoperative radiotherapy was not affected by education level: there was no difference in uptake between patients with secondary and university education and those with compulsory school (OR 1.04 and 0.92).
