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

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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.

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Data availability

All relevant data are disclosed in the paper, its associated figures, and the Supplementary Materials.

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Funding

This work was supported by the Humanities and Social Sciences of Ministry of Education Planning Fund [Grant numbers 20YJAZH007].

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Authors and Affiliations

  1. Department of Hepatobiliary Surgery, Nantong First People’s Hospital, The Second Affiliated Hospital of Nantong University, No. 666 Shengli Road, Nantong, People’s Republic of China

    Bin Zhu

  2. Medical School of Nantong University, Nantong, Jiangsu, People’s Republic of China

    Fei-Hong Hu, Yi-Jie Jia, Dan-Yan Zhao, Wan-Qing Zhang, Wen Tang, Shi-Qi Hu, Meng-Wei Ge, Wei Du & Wang-Qin Shen

  3. School of Public Health, Nantong University, Nantong, Jiangsu, 226001, People’s Republic of China

    Hong-Lin Chen

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Contributions

BZ, F-HH were responsible for the conception; BZ, F-HH were responsible for writing and revision of the paper; Y-JJ, D-YZ, W-QZ had access to the database used to derive the estimates; WT, S-QH, were responsible for extracting and checking data; M-WG, WD, W-QS were responsible for checking the manuscript; the corresponding author (H-LC) had final responsibility to submit the manuscript for publication. All the authors declared that the work described was original research that has not been published previously, and not under consideration for publication elsewhere, in whole or in part. All the authors listed have approved the manuscript that is enclosed.

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Correspondence to Hong-Lin Chen.

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Zhu, B., Hu, FH., Jia, YJ. et al. Socioeconomic status on survival outcomes in patients with colorectal cancer: a cross-sectional study. J Cancer Res Clin Oncol 149, 15641–15655 (2023). https://doi.org/10.1007/s00432-023-05344-3

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