Socioeconomic Disparities Affect Outcomes in Early-Stage Esophageal Adenocarcinoma: A SEER Analysis

Geng, Calvin; Gudur, Anuragh; Radlinski, Mark; Buerlein, Ross C.; Strand, Daniel S.; Sauer, Bryan G.; Shami, Vanessa M.; Wang, Andrew Y.; Podboy, Alexander

doi:10.1016/j.cgh.2023.02.011

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…The reasons underlying the association between lower income and poorer survival in CCA are multifactorial. It has been previously reported for other cancers that access to screening, stage of disease at diagnosis, and even treatment options are influenced by demographic factors, such as race and ethnicity, which ultimately contribute to differences in survival [ 8 , 11 - 13 ]. For cases of iCCA in particular, education level, insurance status, and marital status have been noted as independent predictors of overall survival [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…At present, there are significant treatment variations based on institutional resources and provider expertise [ 6 ]. Socioeconomic status (SES) disparities in cancer-related care have been reported to influence access to advanced treatment interventions for gastrointestinal malignancies, including CCA [ 7 - 9 ]. However, these previous analyses have not included the more recently adopted anatomic classification schema for CCA.…”

Section: Introductionmentioning

confidence: 99%

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Associations between income and survival in cholangiocarcinoma: A comprehensive subtype-based analysis

Geng,

Gudur,

Kadiyala

et al. 2024

Ann Hepatobiliary Pancreat Surg

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Backgrounds/Aims Socioeconomic determinants of health are incompletely characterized in cholangiocarcinoma (CCA). We assessed how socioeconomic status influences initial treatment decisions and survival outcomes in patients with CCA, additionally performing multiple sub-analyses based on anatomic location of the primary tumor. Methods Observational study using the 2018 submission of the Surveillance, Epidemiology, and End Results (SEER)-18 Database. In total, 5,476 patients from 2004−2015 with a CCA were separated based on median household income (MHI) into low income (< 25th percentile of MHI) and high income (> 25th percentile of MHI) groups. Seventy-three percent of patients had complete follow up data, and were included in survival analyses. Survival and treatment outcomes were calculated using R-studio. Results When all cases of CCA were included, the high-income group was more likely than the low-income to receive surgery, chemotherapy, and local tumor destruction modalities. Initial treatment modality based on income differed significantly between tumor locations. Patients of lower income had higher overall and cancer-specific mortality at 2 and 5 years. Non-cancer mortality was similar between the groups. Survival differences identified in the overall cohort were maintained in the intrahepatic CCA subgroup. No differences between income groups were noted in cancer-specific or overall mortality for perihilar tumors, with variable differences in the distal cohort. Conclusions Lower income was associated with higher rates of cancer-specific mortality and lower rates of surgical resection in CCA. There were significant differences in treatment selection and outcomes between intrahepatic, perihilar, and distal tumors. Population-based strategies aimed at identifying possible etiologies for these disparities are paramount to improving patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Associations between income and survival in cholangiocarcinoma: A comprehensive subtype-based analysis

Geng,

Gudur,

Kadiyala

et al. 2024

Ann Hepatobiliary Pancreat Surg

Self Cite

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“…Many studies have reported on the relationship between Median Household Income (MHI) and the prognosis of cancer patients(Bristow et al, 2013;Geng et al, 2023;O'Connor et al, 2018). The ndings from these studies suggest that higher MHI is associated with better prognosis for early-stage esophageal adenocarcinoma, ovarian, or other cancer patients.…”

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confidence: 99%

Socioeconomic status on survival outcomes in patients with colorectal cancer: a cross-sectional study

Zhu,

Hu,

Jia

et al. 2023

J Cancer Res Clin Oncol

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BackgroundColorectal cancer (CRC) is widely acknowledged as a prevalent malignancy and the second most common cause of cancer-related mortality worldwide. The aim of this study was to examine the independent impact of Median Household Income (MHI) on prognosis and survival outcomes in patients with CRC. MethodsData from 17 cancer registries of the United States Surveillance, Epidemiology, and End Results program, with follow-up extended until November 2022 was analyzed. A Cox proportional hazards regression analysis was conducted to evaluate the in uence of different levels of MHI on survival outcomes among patients with CRC. A total of 761,697 CRC patient records were retrieved from the SEER database. ResultsThe Cox regression analysis results indicated that patients with higher MHI exhibited improved overall survival outcomes when compared to those with lower MHI (MMHI: HR = 0.925, 95% CI = 0.916-0.935, P < 0.001; HMHI: HR = 0.861, 95% CI = 0.851-0.870, P < 0.001). Regardless of the speci c tumor location, gender, or treatment method, higher MHI is consistently linked to improved survival outcomes. However, this association was not found to be statistically signi cant among American Indian/Alaska Native

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Frailty and all-cause and cancer-related mortality in cancer patients: A prospective cohort study

Hu,

Feng,

Jia

et al. 2024

European Journal of Oncology Nursing

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Socioeconomic Disparities Affect Outcomes in Early-Stage Esophageal Adenocarcinoma: A SEER Analysis

Cited by 5 publications

References 18 publications

Associations between income and survival in cholangiocarcinoma: A comprehensive subtype-based analysis

Associations between income and survival in cholangiocarcinoma: A comprehensive subtype-based analysis

Socioeconomic status on survival outcomes in patients with colorectal cancer: a cross-sectional study

Frailty and all-cause and cancer-related mortality in cancer patients: A prospective cohort study

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