Abstract
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.Electronic supplementary materialThe online version of this article (doi:10.1186/s12967-015-0579-9) contains supplementary material, which is available to authorized users.
Highlights
Socioeconomic 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
We found a lower percentage of esophageal cancer patients with more than 2 months delay in higher SES group (P = 0.009)
With adjustment for age, gender, tumor location, T stage, N stage, and TNM stage, analysis of the association between SES and health-care delay revealed that shorter delay (≤2 months) was significantly associated with a higher SES
Summary
Socioeconomic 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. Socioeconomic status (SES) is found to be closely related with various cancers, such as hepatocellular cancer, breast cancer, colorectal cancer, and so on [4,5,6,7,8]. These studies mainly focus on the association between SES and the incidence of cancer as well as mortality in cancer. Delayed reporting and late-stage presentation of late rectal sequelae are more prevalent among Chinese cervical cancer patients with low education or poor financial status. Patients with a higher SES underwent a more appropriate treatment modality compared to patients with a lower SES [10]
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