Socioeconomic status and comorbidity among newly diagnosed cancer patients

Schrijvers, Carola; Coebergh, Jan Willem; Mackenbach, Johan P.

doi:10.1002/(sici)1097-0142(19971015)80:8<1482::aid-cncr16>3.0.co;2-1

Cited by 76 publications

(36 citation statements)

References 16 publications

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“…Furthermore, non-death events that occur in adulthood may be missed by POGONIS as they would only be captured if communicated to the treating pediatric center. We were also not able to assess SES-related morbidity in survivors, which has been suggested by other studies [15,38]. Lastly, our study was restricted to the 0-14 age group whereas the majority of HL cases occur in the older age group, where the disease biology and consequently the impact of SES on survival may be different.…”

Section: Discussionmentioning

confidence: 90%

The association between socioeconomic status and survival among children with Hodgkin and non‐Hodgkin lymphomas in a universal health care system

Darmawikarta

Pole

Gupta

et al. 2012

Pediatric Blood & Cancer

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Section: Discussionmentioning

confidence: 90%

The association between socioeconomic status and survival among children with Hodgkin and non‐Hodgkin lymphomas in a universal health care system

Darmawikarta

Pole

Gupta

et al. 2012

Pediatric Blood & Cancer

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“…Only one previous study has specifically addressed the relationship between socio-economic status and comorbidity in patients with colorectal cancer. This was a population-based study from the South-East Netherlands (Schrijvers et al 1997). The assessment of comorbidity was performed retrospectively by clerical staff and there were uncertainties concerning the completeness of reporting.…”

Section: Discussionmentioning

confidence: 99%

Deprivation, comorbidity and survival in a cohort of patients with colorectal cancer

Munro

Bentley

2004

Eur J Cancer Care

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We studied a regionally based cohort of 483 consecutive patients with colorectal cancer referred for chemotherapy and/or radiotherapy. These patients were assessed and managed according to consistent policies. We investigated the effects of socio-economic deprivation and comorbidity upon survival. Significant comorbidity was present in 48% of the patients. Overall survival and cause-specific survival were summarized using Kaplan-Meier curves. Equality of survivor functions was assessed using the logrank procedure and Cox's proportional hazards analysis. In univariate analysis, the following variables significantly affected survival: comorbidity, performance status, age and clinical stage. We could find no correlation between deprivation and comorbidity. The presence of comorbidity significantly affected cause-specific survival (3-year cause-specific survival without comorbidity 54.2%; with comorbidity 44.6%). In adjusted analysis, deprivation had an independently adverse effect on overall survival, hazard ratio 1.04 (95% confidence interval 1.00-1.08), but this was only of borderline statistical significance, P = 0.049. This study demonstrates that the interrelationships between comorbidity, deprivation and outcome in this group of patients are complex: even when care is readily available, patient assessments are uniform, and clinical decision making is consistent.

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“…This was particularly pronounced in the case of genetic testing: a Charlson comorbidity index of 3 or higher was the explanatory measure most negatively associated with testing. EGFR testing usually requires biopsy (32), a surgical procedure that may present risks for patients with more comorbidities, and there is a well-established relationship between lower socioeconomic status and higher comorbidity level (33,34). Thus, although low socioeconomic status per se may not impede access to genetic testing, the higher comorbidity rate in low-SES populations appears to create a de facto socioeconomic disparity.…”

Section: Discussionmentioning

confidence: 99%

Disparities and Trends in Genetic Testing and Erlotinib Treatment among Metastatic Non–Small Cell Lung Cancer Patients

Palazzo

Sheehan

Tramontano

et al. 2019

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Despite reports of socioeconomic disparities in rates of genetic testing and targeted therapy treatment for metastatic non-small cell lung cancer (NSCLC), little is known about whether such disparities are changing over time.Methods: We performed a retrospective analysis to identify disparities and trends in genetic testing and treatment with erlotinib. Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, we identified 9,900 patients with stage IV NSCLC diagnosed in 2007 to 2011 at age 65 or older. We performed logistic regression analyses to identify patient factors associated with odds of receiving a genetic test and erlotinib treatment, and to assess trends in these differences with respect to diagnosis year.Results: Patients were more likely to receive genetic testing if they were under age 75 at diagnosis [odds ratio (OR), 1.55] independent of comorbidity level, and this age-based gap showed a decrease over time (OR, 0.93). For untested patients, erlotinib treatment was associated with race (OR, 0.58, black vs. white; OR, 2.45, Asian vs. white), and was more likely among female patients (OR, 1.45); for tested patients, erlotinib treatment was less likely among low-income patients (OR, 0.32). Most of these associations persisted or increased in magnitude.Conclusions: Race and sex are associated with rates of erlotinib treatment for patients who did not receive genetic testing, and low-income status is associated with treatment rates for those who did receive testing. The racial disparity remained stable over time, while the income-based disparity grew larger.Impact: Attention to reducing disparities is needed as precision cancer treatments continue to be developed.

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Socioeconomic status and comorbidity among newly diagnosed cancer patients

Abstract: Socioeconomic variation in the prevalence of serious comorbidity at the time of diagnosis does exist in some cancer sites, which may explain (partly) the socioeconomic gradient in survival observed in patients with tumors in these sites.

Cited by 76 publications

References 16 publications

The association between socioeconomic status and survival among children with Hodgkin and non‐Hodgkin lymphomas in a universal health care system

The association between socioeconomic status and survival among children with Hodgkin and non‐Hodgkin lymphomas in a universal health care system

Deprivation, comorbidity and survival in a cohort of patients with colorectal cancer

Disparities and Trends in Genetic Testing and Erlotinib Treatment among Metastatic Non–Small Cell Lung Cancer Patients

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