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

J Cancer Res Clin Oncol. 2023 Nov;149(17):15641-15655. doi: 10.1007/s00432-023-05344-3. Epub 2023 Sep 1.

Abstract

Background: Colorectal 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.

Methods: Data 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 influence 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.

Results: The Cox regression analysis results indicated that patients with higher MHI exhibited improved overall survival outcomes when compared to those with lower MHI (MMHI: P < 0.001; HMHI: P < 0.001). Regardless of the specific tumor location, gender, stage of CRC, or treatment method, higher MHI is consistently linked to improved survival outcomes. However, this association was not found to be statistically significant among American Indian/Alaska Native (MMHI: P = 0.017; HMHI: P = 0.081), Asian or Pacific Islander (MMHI: P = 0.223; HMHI: P = 0.002) and unmarried or domestic partner patients (MMHI: P = 0.311; HMHI: P = 0.011).

Conclusion: These results emphasize the importance of considering socioeconomic factors, such as income level, in understanding and addressing disparities in survival outcomes of CRC patients.

Keywords: Colorectal; Median household income; SEER; Socioeconomic status; Survival.

MeSH terms

  • Colorectal Neoplasms* / pathology
  • Cross-Sectional Studies
  • Humans
  • Neoplasm Staging
  • SEER Program
  • Social Class
  • Socioeconomic Factors
  • United States / epidemiology