Associations of Education Level With Survival Outcomes and Treatment Receipt in Patients With Gastric Adenocarcinoma

Abstract

BackgroundIt remains largely unclear how education level, an important socioeconomic factor, affects prognoses for patients with gastric adenocarcinoma (GAC). We aimed to demonstrate the associations between education level and clinical outcomes in patients with GAC.MethodsWe included a total of 30,409 patients diagnosed with GAC from the Surveillance, Epidemiology, and End Results 18 registry database. Education level, household income, unemployment rate, poverty rate, insurance status, and marital status were selected as sociodemographic variables for the comprehensive analysis. Cox and logistic regression models, Kaplan–Meier curves, and subgroup analyses were the primary statistical methods employed.ResultsA low level of education was correlated with less income, higher unemployment rates, and higher poverty rates (all p < 0.001). The multivariate Cox analysis indicated that a high education level was significantly associated with superior overall survival rates and cancer-specific survival rates in patients with GAC (both p < 0.001). We also corroborated favorable survival outcomes by high education level within almost every clinical and demographic subgroup. Furthermore, chemotherapy combined with surgery could markedly prolong the survival for all patients, including patients of stage IV cancer (both p < 0.001). By using multivariable logistic models, patients in counties with high education levels had a higher probability of chemotherapy receipt (p < 0.001). Contrarily, those in the counties with low levels of education were less likely to receive chemotherapy or undergo surgery (p < 0.001).ConclusionsEducation level was identified and confirmed as an independent predictor of treatment and survival for GAC patients. Efforts are needed to provide effective interventions for those whose educational status is adverse.

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“…This research also indicated that educational level was closely related to the prognosis of recipients, which might be inseparable from the post-transplant nursing care of patients. We observed a similar phenomenon in other diseases, where highly educated patients with gastric cancer and those who underwent knee surgery had better outcomes than those with low levels of education ( 15 , 16 ). A better educational background can help patients understand basic health information related to their disease, resulting in better adherence to immunosuppressive drugs after kidney transplantation.…”

The quality of life in nasopharyngeal carcinoma radiotherapy: A longitudinal study

“…These factors collectively contribute to a more favorable health outcome. 42 , 43 , 44 Therefore, it is suggested that clinical practitioners should pay attention to patients with low education level and provide more tailored support where necessary.…”