The effect of socioeconomic deprivation on presentation stage and long-term outcomes in patients undergoing colorectal cancer resection in Western Sydney
| Autor: | James A. Pasch, Kar Yin Fok, Krishna Kotecha, Walid Barto, Lachlan Pasch, Chatika Premaratne, Ewan MacDermid, Toufic El Khoury |
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| Rok vydání: | 2021 |
| Předmět: |
education.field_of_study
Univariate analysis medicine.medical_specialty Colorectal cancer business.industry Population Ethnic group Australia General Medicine Disease Kaplan-Meier Estimate medicine.disease Colorectal surgery Socioeconomic Factors medicine Humans Surgery Stage (cooking) education business Colorectal Neoplasms Socioeconomic status Demography Aged Neoplasm Staging |
| Zdroj: | ANZ journal of surgeryREFERENCES. 91(7-8) |
| ISSN: | 1445-2197 |
| Popis: | Background While socioeconomic deprivation has been shown to affect survival in colorectal cancer, other factors such as global region of birth and ethnicity also exert an effect. We wished to ascertain the influence of socioeconomic deprivation on stage of presentation and cancer survival in an ethnically diverse Australian population. Methods Cases from a database of resections in Western Sydney (n = 1596) were stratified into cohorts of socioeconomic quintiles. Univariate analysis was used to compare demographics, AJCC stage and histopathological details between the least and most socioeconomically deprived groups. Kaplan-Meier analysis and log-rank testing were used to compare cancer-specific and all-cause 5-year survival between the most deprived quintile and all others, after case-control matching for age and overseas birth. Results A total of 322 (20.2%) patients from the most socioeconomically deprived centile, and 275 (17.2%) from the least were compared. The most deprived were significantly more likely to be aged under 70 (54.1% vs. 44.4%, p = 0.019), born overseas (54.3% vs. 38.6%, p = 0.003), present with stage III disease (37.4% vs. 26.7%, p = 0.005), perforated (12.5% vs. 5.3%, p = 0.005) or circumferential tumours (37% vs. 24.3%, p = 0.043). There was no significant difference in proportions presenting with metastatic disease, or 5-year survival between the most deprived quintile and all others after correction for age and foreign birth. Conclusions Socioeconomic deprivation is associated with unfavourable colorectal cancer presentation stage but not poorer 5-year survival in our Western Sydney population. The reasons for this are unclear and demand further attention. |
| Databáze: | OpenAIRE |
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