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The role of socioeconomic disparity in colorectal cancer stage at presentation

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Abstract

Colorectal cancer, despite multiple screening measures being available, is the second leading cause of death due to cancer. Cancer stage at diagnosis is an important determinant of survival, where earlier stages have significantly increased rates of survival. By looking at various social health disparities (at a patient and geographic level) and their effect on stage at presentation, we will gain a better understanding of the effect they have on cancer outcomes. Data were collected from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database for the years 2007–2014. Covariates extracted were patient-level variables such as age, race, primary site, state/county, insurance status as well as county-level data which included percent urban population, median family income, rural–urban continuum code classification, percent of population that has not completed high school, percent of population below the poverty line, percent of population foreign-born, percent of language-isolated persons, and unemployment rate. The primary outcome analyzed was cancer staging at diagnosis. A χ2 analysis and multivariate binary logistic regression was modeled to elucidate the associations between study covariates and late stage of cancer presentation. Chi-squared analysis demonstrated significant associations (at p < 0.05) between stage of diagnosis with race, age, insurance status, location of primary site, percent of population below poverty line, percent of language-isolated persons, and percent of unemployed. To help reduce these disparities, community resources and increased screening and prevention techniques must be implemented to target the unique populations at greatest risk for developing the disease.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Surgery, Rutgers-New Jersey Medical School, 185 South Orange Avenue, Suite MSB G530, Newark, NJ, USA

    Aesha Patel, Owen Gantz & Aziz M. Merchant

  2. Clinical Outcomes Research Group, CORG LLC, 178 Meadow Brook Road, Grantham, NH, 03753, USA

    Pavel Zagadailov

Authors
  1. Aesha Patel
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  2. Owen Gantz
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  3. Pavel Zagadailov
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  4. Aziz M. Merchant
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Contributions

All authors of this manuscript have made substantial contributions to the conception and design of the study, and data analysis and interpretation. Drafting and revising the manuscript. Final approval of the manuscript submission.

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Correspondence to Aziz M. Merchant.

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Patel, A., Gantz, O., Zagadailov, P. et al. The role of socioeconomic disparity in colorectal cancer stage at presentation. Updates Surg 71, 523–531 (2019). https://doi.org/10.1007/s13304-019-00632-5

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