Abstract A053: Association between socioeconomic status and access to specialized cancer consultation and treatment among advanced gastrointestinal cancers

Abstract

Abstract Introduction: Gastrointestinal (GI) cancers of the pancreas, esophagus, stomach, colon and rectum often present at an incurable stage. Treatments such as chemotherapy and radiotherapy can improve quality and quantity of life for patients with these advanced gastrointestinal (GI) cancers. However, many patients fail to receive such treatments or even consult with a cancer specialist to determine if treatment is an option. Socioeconomic status (SES) is associated with cancer outcomes, but the mechanisms as to why, such as access to specialized care, are not clearly established. This study examined the association between SES and receipt of specialized cancer consult and treatment in Ontario, Canada. Methods: This was a population-based retrospective cohort study of advanced GI cancer patients diagnosed between 2007 and 2017 using linked administrative databases. The exposure of SES was defined using the deprivation item in the Ontario Marginalization Index. The outcome of oncology consult was defined as a consultation with either a radiation oncologist or a medical oncologist and the outcome of treatment was defined as receipt of chemotherapy or radiotherapy. Both were measured in the year following diagnosis. Multivariable Cox-proportional hazards regression models were used to determine association of deprivation with oncology consult and treatment. Confounders identified a priori include age, sex, comorbidities and cancer site. Results: 29,297 patients had a diagnosis of advanced GI cancer and were included in the study. 27.4% of the cohort did not have an oncology consult and 53.7% did not receive treatment in the year following diagnosis. The most deprived quintile compared to the least deprived quintile was associated with decreased consult (HR 0.89 (0.85-0.93)) and decreased treatment (HR 0.81 (0.77-0.86)) after adjusting for confounders. Conclusion: This study found that even in a single-payer universal healthcare system, SES is associated with access to specialized cancer care. Future research should examine mechanisms through which policy might help low SES patients access specialized cancer care. Citation Format: Laura E Davis, Natalie G Coburn, Julie Hallet, Craig C Earle, Sten Myrehaug, Ying Li, Alyson L Mahar. Association between socioeconomic status and access to specialized cancer consultation and treatment among advanced gastrointestinal cancers [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 A053.