Abstract A049: Socioeconomic disparities in treatment delays and survival for anal cancer patients

Abstract

Abstract Background: Socioeconomic status (SES) is associated with treatment delays and survival in multiple cancers, but less data exist for anal squamous cell carcinoma (ASCC). This study investigated the association between SES and outcomes for patients undergoing definitive chemoradiation therapy for ASCC. Methods: Patients diagnosed with non-metastatic ASCC between 2005 and 2018 were retrospectively reviewed. Socioeconomic predictor variables included primary payer, race, income, employment, and partnership status. Outcomes included tumor-node (TN) stage at diagnosis, the interval from diagnosis to treatment initiation, relapse-free survival (RFS), and overall survival (OS). Age, gender, TN stage, and HIV status were analyzed as covariates in survival analysis. Results: Over the study period, 111 patients met inclusion criteria. SES was not associated with the TN stage at diagnosis. SES factors associated with treatment delays were Medicaid payer (p = 0.016) and single partnership status (p = 0.016). Compared to privately insured patients, Medicaid patients had lower two-year RFS (64.4% vs. 93.8%, p = 0.021) and OS (82.9% vs. 93.5%, p = 0.038). Similarly, relative to patients in the racial majority, racial minority patients had lower two-year RFS (53.3% vs. 93.5%, p = 0.001) and OS (73.7% vs. 92.6%, p = 0.008). Race was an independent predictor for both RFS (p = 0.027) and OS (p = 0.047). Conclusions: These results highlight the impact of social contextual factors on health. Interventions targeted at socioeconomically vulnerable populations are needed to reduce disparities in ASCC outcomes. Citation Format: Tessnim R Ahmad, Matthew Susko, Karla Lindquist, Mekhail Anwar. Socioeconomic disparities in treatment delays and survival for anal cancer patients [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A049.