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Published in: Journal of Gastrointestinal Surgery 4/2012

01-04-2012 | 2011 SSAT Poster Presentation

Socioeconomic Factors Impact Colon Cancer Outcomes in Diverse Patient Populations

Authors: Wendy Lee, Rebecca Nelson, Brian Mailey, Marjun Philip Duldulao, Julio Garcia-Aguilar, Joseph Kim

Published in: Journal of Gastrointestinal Surgery | Issue 4/2012

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Abstract

Purpose

Cancer disparities among racial and ethnic groups are major public health concerns. Our objective was to examine the impact of socioeconomic status (SES) on survival of colon cancer patients within major racial and ethnic groups.

Methods

Patients with colon adenocarcinoma from Los Angeles County (LAC) were assessed. SES was utilized as an indicator of healthcare access and categorized by tertiles (high, middle, and low). Patient characteristics were compared and survival analyses were performed.

Results

In our heterogeneous LAC cohort, we confirmed survival disparities. Asians had the best survival followed by Hispanics, whites, and blacks. For each stage of disease, Asians and Hispanics had better outcomes than whites and blacks. Then, we evaluated the impact of SES on survival within each racial and ethnic group. We observed significantly longer survival for high SES patients compared to middle and low SES patients for all racial/ethnic groups.

Conclusions

While disparities across racial/ethnic groups are well-documented, our study is the first to identify socioeconomic disparities in survival for patients within the same group. These novel findings demonstrate the complex role of SES on race and ethnicity and identify the need to improve healthcare access even within select populations.
Literature
1.
2.
go back to reference Ananthakrishnan A, Schellhase K, Sparapani R, Laud P, Neuner J. Disparities in colon cancer screening in the Medicare population. Arch Intern Med. 2007;167(3):258–264.PubMedCrossRef Ananthakrishnan A, Schellhase K, Sparapani R, Laud P, Neuner J. Disparities in colon cancer screening in the Medicare population. Arch Intern Med. 2007;167(3):258–264.PubMedCrossRef
3.
go back to reference Rhoads K, Ackerson L, Jha A, Dudley R. Quality of colon cancer outcomes in hospitals with a high percentage of Medicaid patients. J Am Coll Surg. 2008;207(2):197–204.PubMedCrossRef Rhoads K, Ackerson L, Jha A, Dudley R. Quality of colon cancer outcomes in hospitals with a high percentage of Medicaid patients. J Am Coll Surg. 2008;207(2):197–204.PubMedCrossRef
4.
go back to reference VanEenwyk J, Campo J, Osslander E. Socioeconomic and demographic disparities in treatment for carcinomas of the colon and rectum. Cancer. 2002;95(1):39–46.PubMedCrossRef VanEenwyk J, Campo J, Osslander E. Socioeconomic and demographic disparities in treatment for carcinomas of the colon and rectum. Cancer. 2002;95(1):39–46.PubMedCrossRef
5.
go back to reference Adler N, Newman K. Socioeconomic disparities in health: pathways and policies. Health Affairs. 2002;21:60–76.PubMedCrossRef Adler N, Newman K. Socioeconomic disparities in health: pathways and policies. Health Affairs. 2002;21:60–76.PubMedCrossRef
6.
go back to reference Sorlie P, Backlund E, Keller J. US mortality by economic, demographic, and social characteristics: the National Longitudinal Mortality Study. Am J Public Health. 1995;85:949–956.PubMedCrossRef Sorlie P, Backlund E, Keller J. US mortality by economic, demographic, and social characteristics: the National Longitudinal Mortality Study. Am J Public Health. 1995;85:949–956.PubMedCrossRef
7.
go back to reference Liu L, Cozen W, Bernstein L, Ross R, Deapen D. Changing relationship between socioeconomic status and prostate cancer incidence. J Natl Cancer Inst. 2001;93(9):705–709.PubMedCrossRef Liu L, Cozen W, Bernstein L, Ross R, Deapen D. Changing relationship between socioeconomic status and prostate cancer incidence. J Natl Cancer Inst. 2001;93(9):705–709.PubMedCrossRef
8.
go back to reference Krieger N, Chen J, Waterman P, Rehkopf D, Yin R, Coull B. Race/ethnicity and changing US socioeconomic gradients in breast cancer incidence: California and Massachusetts, 1978–2002 (United States). Cancer Causes Control. 2006;17(2):217–226.PubMedCrossRef Krieger N, Chen J, Waterman P, Rehkopf D, Yin R, Coull B. Race/ethnicity and changing US socioeconomic gradients in breast cancer incidence: California and Massachusetts, 1978–2002 (United States). Cancer Causes Control. 2006;17(2):217–226.PubMedCrossRef
9.
go back to reference Doubeni C, Laiyemo A, Young A, et al. Primary care, economic barriers to health care, and use of colorectal cancer screening tests among Medicare enrollees over time. Ann Fam Med. 2010;8(4):299–307.PubMedCrossRef Doubeni C, Laiyemo A, Young A, et al. Primary care, economic barriers to health care, and use of colorectal cancer screening tests among Medicare enrollees over time. Ann Fam Med. 2010;8(4):299–307.PubMedCrossRef
10.
go back to reference Artinyan A, Mailey B, Sanchez-Luege N, et al. Race, ethnicity, and socioeconomic status influence the survival of patients with hepatocellular carcinoma in the United States. Cancer. 2010;116(5):1367–1377.PubMedCrossRef Artinyan A, Mailey B, Sanchez-Luege N, et al. Race, ethnicity, and socioeconomic status influence the survival of patients with hepatocellular carcinoma in the United States. Cancer. 2010;116(5):1367–1377.PubMedCrossRef
11.
go back to reference Wong M, Ettner S, Boscardin W, Shapiro M. The contribution of cancer incidence, stage at diagnosis and survival to racial differences in years of life expectancy. J Gen Intern Med. 2009;24(4):475–481.PubMedCrossRef Wong M, Ettner S, Boscardin W, Shapiro M. The contribution of cancer incidence, stage at diagnosis and survival to racial differences in years of life expectancy. J Gen Intern Med. 2009;24(4):475–481.PubMedCrossRef
12.
go back to reference Kim J, Artinyan A, Mailey B, et al. An interaction of race and ethnicity with socioeconomic status in rectal cancer outcomes. Ann Surg. 2011;253:647–654.PubMedCrossRef Kim J, Artinyan A, Mailey B, et al. An interaction of race and ethnicity with socioeconomic status in rectal cancer outcomes. Ann Surg. 2011;253:647–654.PubMedCrossRef
13.
go back to reference Le H, Ziogas A, Lipkin S, Zell J. Effects of socioeconomic status and treatment disparities in colorectal cancer survival. Cancer Epidemiol Biomarkers Prev. 2008;17(8):1950–1962.PubMedCrossRef Le H, Ziogas A, Lipkin S, Zell J. Effects of socioeconomic status and treatment disparities in colorectal cancer survival. Cancer Epidemiol Biomarkers Prev. 2008;17(8):1950–1962.PubMedCrossRef
14.
go back to reference Berry J, Bumpers K, Ogunlade V, et al. Examining racial disparities in colorectal cancer care. J Psychosoc Oncol. 2009;27(1):59–83.PubMedCrossRef Berry J, Bumpers K, Ogunlade V, et al. Examining racial disparities in colorectal cancer care. J Psychosoc Oncol. 2009;27(1):59–83.PubMedCrossRef
15.
go back to reference Du X, Lin C, Johnson N, Altekruse S. Effects of individual-level socioeconomic factors on racial disparities in cancer treatment and survival. Cancer. 2011;117:3242–3251.PubMedCrossRef Du X, Lin C, Johnson N, Altekruse S. Effects of individual-level socioeconomic factors on racial disparities in cancer treatment and survival. Cancer. 2011;117:3242–3251.PubMedCrossRef
16.
go back to reference Du X, Meyer T, Franzini L. Meta-analysis of racial disparities in survival in association with socioeconomic status among men and women with colon cancer. Cancer. 2007;109(11):2161–2170.PubMedCrossRef Du X, Meyer T, Franzini L. Meta-analysis of racial disparities in survival in association with socioeconomic status among men and women with colon cancer. Cancer. 2007;109(11):2161–2170.PubMedCrossRef
17.
go back to reference Baldwin L, Dobie S, Billingsley K, et al. Explaining black-white differences in receipt of recommended colon cancer treatment. J Natl Cancer Inst. 2005;97(16):1211–1220.PubMedCrossRef Baldwin L, Dobie S, Billingsley K, et al. Explaining black-white differences in receipt of recommended colon cancer treatment. J Natl Cancer Inst. 2005;97(16):1211–1220.PubMedCrossRef
18.
go back to reference Rim S, Seeff L, Ahmed F, King J, Coughlin S. Colorectal cancer incidence in the United States, 1999–2004. Cancer. 2009;115(9):1967–1976.PubMedCrossRef Rim S, Seeff L, Ahmed F, King J, Coughlin S. Colorectal cancer incidence in the United States, 1999–2004. Cancer. 2009;115(9):1967–1976.PubMedCrossRef
19.
go back to reference Howard G, Anderson R, Russell G, Howard V, Burke G. Race, socioeconomic status, and cause-specific mortality. Ann Epidemiol. 2000;10:214–223.PubMedCrossRef Howard G, Anderson R, Russell G, Howard V, Burke G. Race, socioeconomic status, and cause-specific mortality. Ann Epidemiol. 2000;10:214–223.PubMedCrossRef
20.
go back to reference Gomez S, Glaser S, McClure, LA, Shema S, Kealey M, Keegan T, Satariano W. The California Neighborhoods Data System: a new resource for examining the impact of neighborhood characteristics on cancer incidence and outcomes in populations. Cancer Causes Control. 2011;22(4):631–647.PubMedCrossRef Gomez S, Glaser S, McClure, LA, Shema S, Kealey M, Keegan T, Satariano W. The California Neighborhoods Data System: a new resource for examining the impact of neighborhood characteristics on cancer incidence and outcomes in populations. Cancer Causes Control. 2011;22(4):631–647.PubMedCrossRef
21.
go back to reference Sudano J, Baker D. Explaining US racial/ethnic disparities in health declines and mortality in late middle age: the roles of socioeconomic status, health behaviors, and helath insurance. Soc Sci Med. 2006;62(4):909–922.PubMedCrossRef Sudano J, Baker D. Explaining US racial/ethnic disparities in health declines and mortality in late middle age: the roles of socioeconomic status, health behaviors, and helath insurance. Soc Sci Med. 2006;62(4):909–922.PubMedCrossRef
22.
go back to reference Le H, Ziogas A, Taylor T, Lipkin S, Zell J. Survival of distinct Asian groups among colorectal cancer cases in California. Cancer. 2009;115(2):259–270.PubMedCrossRef Le H, Ziogas A, Taylor T, Lipkin S, Zell J. Survival of distinct Asian groups among colorectal cancer cases in California. Cancer. 2009;115(2):259–270.PubMedCrossRef
23.
go back to reference Jessup J, Stewart A, Greene F, Minsky B. Adjuvant chemotherapy for Stage III colon cancer: implications of race/ethnicity, age, and differentiation. JAMA. 2005;294(21):2703–2711.PubMedCrossRef Jessup J, Stewart A, Greene F, Minsky B. Adjuvant chemotherapy for Stage III colon cancer: implications of race/ethnicity, age, and differentiation. JAMA. 2005;294(21):2703–2711.PubMedCrossRef
Metadata
Title
Socioeconomic Factors Impact Colon Cancer Outcomes in Diverse Patient Populations
Authors
Wendy Lee
Rebecca Nelson
Brian Mailey
Marjun Philip Duldulao
Julio Garcia-Aguilar
Joseph Kim
Publication date
01-04-2012
Publisher
Springer-Verlag
Published in
Journal of Gastrointestinal Surgery / Issue 4/2012
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-011-1809-y

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