个体和肿瘤因素只能解释英格兰结直肠癌存活率不平等现象的一部分。本研究旨在调查结直肠癌患者治疗的不平等。从2012年至2016年在英格兰被诊断为结直肠癌的所有患者，都从诊断日（状态1）开始随访，到治疗（状态2）、死亡（状态3）或在诊断后1年被截尾。采用灵活参数模型进行的多状态方法用于研究收入剥夺对结直肠癌患者存活和接受治疗的概率的影响。与最不剥夺的五分之一相比，最剥夺的I-IV期结直肠癌患者在随访期间的存活和接受治疗的概率较低，并且未接受治疗和死亡的概率较高。（最剥夺与最不剥夺之间）6个月存活和接受治疗的概率差异（最剥夺与最不剥夺）在结肠癌中范围为-2.4%（95% CI：-4.3，-1.1）至-7.4%（-9.4，-5.3）；在直肠癌中范围为-2.0%（-3.5，-0.4）至-6.2%（-8.9，-3.5）。观察到结直肠癌患者在每个阶段治疗的不平等性持续存在，这是由于治疗受限和过早死亡造成的。© 2023.作者。

Individual and tumour factors only explain part of observed inequalities in colorectal cancer survival in England. This study aims to investigate inequalities in treatment in patients with colorectal cancer.All patients diagnosed with colorectal cancer in England between 2012 and 2016 were followed up from the date of diagnosis (state 1), to treatment (state 2), death (state 3) or censored at 1 year after the diagnosis. A multistate approach with flexible parametric model was used to investigate the effect of income deprivation on the probability of remaining alive and treated in colorectal cancer.Compared to the least deprived quintile, the most deprived with stage I-IV colorectal cancer had a lower probability of being alive and treated at all the time during follow-up, and a higher probability of being untreated and of dying. The probability differences (most vs. least deprived) of being alive and treated at 6 months ranged between -2.4% (95% CI: -4.3, -1.1) and -7.4% (-9.4, -5.3) for colon; between -2.0% (-3.5, -0.4) and -6.2% (-8.9, -3.5) for rectal cancer.Persistent inequalities in treatment were observed in patients with colorectal cancer at every stage, due to delayed access to treatment and premature death.© 2023. The Author(s).