The effect of socioeconomic status on health-care delay and treatment of esophageal cancer

Journal of Translational Medicine

Research

Fang Liu¹  Nana Wang²  Yibin Jia²  Xintong Wang²  Yufeng Cheng²  Cihang Bao²  Bingxu Tan²  Qingxu Song²  Jianbo Wang²  Fangli Cao³ 

[1] Department of Image, Shandong Medical College, Jinan, People’s Republic of China;Department of Radiation Oncology, Qilu Hospital of Shandong University, 107 West Wenhua Road, 250012, Jinan, People’s Republic of China;Department of Radiation Oncology, Qilu Hospital of Shandong University, 107 West Wenhua Road, 250012, Jinan, People’s Republic of China;Department of Oncology, Liaocheng People’s Hospital, Liaocheng, People’s Republic of China;

关键词: Esophageal cancer;    Socioeconomic status;    Delay;    Stage;    Treatment;   

DOI  :  10.1186/s12967-015-0579-9

 received in 2014-10-29, accepted in 2015-06-23,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundSocioeconomic status (SES) has been focused on as a key determinant of the incidence of cancer, cancer stage at diagnosis as well as treatment choices in western countries. However, to the authors’ knowledge, little work has been done concerning the relationship of SES and esophageal cancer in China.MethodsPatients diagnosed with primary esophageal cancer from January to December 2007 in Qilu hospital were included. Socioeconomic status was determined by a questionnaire including religion, years of schooling and high education, place of residence, occupation, annual household income, and insurance.ResultsA total of 238 cases were collected in this study. Linear-by-linear association testing revealed that health-care delay was significantly associated with SES (P = 0.009). Multivariable logistic regression analysis revealed that increased health-care delay (>2 months) was more frequently observed in patients with lower SES (OR 2.271; 95% CI 1.069–4.853). Patients diagnosed at TNM I and II were more frequently in higher SES groups (P = 0.017). The association test was statistically significant for undergoing surgical resection only (P = 0.015) and chemotherapy (P = 0.015). Multivariable logistic regression analysis revealed that surgical resection only was less performed in higher SES group compared with lower SES group (OR 0.372; 95% CI 0.188–0.734). For chemotherapy, higher SES patients had a three-fold higher likelihood compared with lower SES group (OR 3.042; 95% CI 1.335–6.928).ConclusionSocioeconomic status was found to be associated with health-care delay, tumor stage and treatment modalities in esophageal cancer.

【 授权许可】

CC BY   
© Wang et al. 2015