Effects of socioeconomic status on cancer patient survival: counterfactual event-based mediation analysis

Lin, Shi‐Woei; Anisa, Kartika Nur

doi:10.1007/s10552-020-01361-6

Cited by 8 publications

(5 citation statements)

References 31 publications

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“…The findings of this study confirm the growing body of evidence on the significant impact of neighborhood deprivation on cancer survival outcomes [2,[18][19][20][21][22][23][24][25]. One of the most consequential impacts of neighborhood deprivation is the tendency toward latestage cancer diagnosis.…”

Section: Discussionsupporting

confidence: 84%

“…In particular, socioeconomic disparities remain a significant concern, reflecting inequalities in the social determinants of health. Research has shown that neighborhood deprivation affects an individual's overall health, often resulting in a vicious cycle of poor health, limited access to care, and continued poverty [2,3]. Specifically, cancer patients from underprivileged areas often experience various challenges, including lack of essential healthcare resources, fragmented social support systems, limited accessibility to medical facilities, and deprived resources [4,5].…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Neighborhood Deprivation on the Survival Rates of Patients with Cancer in Korea

Jung,

Shin,

Jung

et al. 2023

Healthcare

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The objective of this study is to investigate the correlation between the neighborhood deprivation index and survival rates of cancer patients in Korea. In this study, 5-year age-standardized survival rates of patients with cancer were determined using the National Cancer Cohort from 2014 to 2018 in Korea. The primary cancer sites were the stomach, colorectum, liver, lung, breast, cervix, prostate, and thyroid. Disparities were measured, and their impact on the overall survival rates was assessed using the Korean version of the Neighborhood Deprivation Index. Pearson’s correlation coefficient was calculated to determine the strength of the correlation. The study cohort comprised 726,665 patients with cancer, of whom 50.7% were male. The predominant primary cancer sites were the stomach (n = 138,462), colorectum (n = 125,156), and thyroid gland (n = 120,886). Urban residents showed better survival outcomes than those situated in rural areas. The most deprived quartile had the lowest survival rate, while the least deprived quartile had the highest (p < 0.001). Most cancer types revealed significant correlations between neighborhood deprivation and 5-year age-standardized overall survival, with lung cancer showing the most substantial negative correlation (r = −0.510), followed by prostate cancer (r = −0.438). However, thyroid cancer showed only a marginal correlation (p = 0.069). The results of this study suggested that neighborhood deprivation is closely linked to disparities in overall survival across various types of cancer. A substantial negative correlation between the neighborhood deprivation index and all-cause mortality for lung and prostate cancer, as compared to breast and cervical cancers covered by the National Cancer Screening Program, may reinforce the need to address healthcare access and improve the early detection of cancer in socioeconomically deprived neighborhoods.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

The Impact of Neighborhood Deprivation on the Survival Rates of Patients with Cancer in Korea

Jung,

Shin,

Jung

et al. 2023

Healthcare

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“…SEER-based studies may also employ several other research methodologies. For example, mediation analysis is typically used to identify the indirect impact of a covariate on cancer survival through one or a few mediating factors [ 82 , 83 ]. Possible interactions of treatment and other variables with mortality have been explored in subgroup analysis, which could enhance the reliability of the results [ 84 , 85 ].…”

Section: Methodsmentioning

confidence: 99%

How to use the Surveillance, Epidemiology, and End Results (SEER) data: research design and methodology

Che,

Li,

Tsang

et al. 2023

Military Med Res

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In the United States (US), the Surveillance, Epidemiology, and End Results (SEER) program is the only comprehensive source of population-based information that includes stage of cancer at the time of diagnosis and patient survival data. This program aims to provide a database about cancer incidence and survival for studies of surveillance and the development of analytical and methodological tools in the cancer field. Currently, the SEER program covers approximately half of the total cancer patients in the US. A growing number of clinical studies have applied the SEER database in various aspects. However, the intrinsic features of the SEER database, such as the huge data volume and complexity of data types, have hindered its application. In this review, we provided a systematic overview of the commonly used methodologies and study designs for retrospective epidemiological research in order to illustrate the application of the SEER database. Therefore, the goal of this review is to assist researchers in the selection of appropriate methods and study designs for enhancing the robustness and reliability of clinical studies by mining the SEER database.

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“…In countries with public health care, low SES may affect health outcomes both directly and indirectly 14 . Lower SES individuals may not be able to take time away from work or afford child care to receive care or recover from invasive procedures, and underserved neighborhoods may lack physicians and health care resources or adequate transportation options for residents to seek out care or referrals 15,16 . Altogether, systemic inequalities and lack of resources may combine to result in worse outcomes for people with lower SES 17 …”

Section: Introductionmentioning

confidence: 99%

“…14 Lower SES individuals may not be able to take time away from work or afford child care to receive care or recover from invasive procedures, and underserved neighborhoods may lack physicians and health care resources or adequate transportation options for residents to seek out care or referrals. 15,16 Altogether, systemic inequalities and lack of resources may combine to result in worse outcomes for people with lower SES. 17 The relationship between neighborhood SES and cancer outcomes has previously been evaluated in the Canadian context, primarily in Ontario.…”

Section: Introductionmentioning

confidence: 99%

The association between neighborhood‐level income and cancer stage at diagnosis and survival in Alberta

Ruan,

Heer,

Warkentin

et al. 2023

Cancer

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BackgroundSocioeconomic status (SES) is associated with a range of health outcomes, including cancer diagnosis and survival. However, the evidence for this association is inconsistent between countries with and without single‐payer health care systems. In this study, the relationships between neighborhood‐level income, cancer stage at diagnosis, and cancer‐specific mortality in Alberta, Canada, were evaluated.MethodsThe Alberta Cancer Registry was used to identify all primary cancer diagnoses between 2010 and 2020. Average neighborhood income was determined by linking the Canadian census to postal codes and was categorized into quintiles on the basis of income distribution in Alberta. Multivariable multinomial logistic regression was used to model the association between income quintile and stage at diagnosis, and the Fine–Gray proportional subdistribution hazards model was used to estimate the association between SES and cancer‐specific mortality.ResultsOut of the 143,818 patients with cancer included in the study, those in lower income quintiles were significantly more likely to be diagnosed at stage III (odds ratio [OR], 1.07; 95% CI [confidence interval], 1.06–1.09) or IV (OR, 1.12; 95% CI, 1.11–1.14) after adjusting for age and sex. Lower income quintiles also had significantly worse cancer‐specific survival for breast, colorectal, liver, lung, non‐Hodgkin lymphoma, oral cavity, pancreas, and prostate cancers.ConclusionsDisparities were observed in cancer outcomes across neighborhood‐level income groups in Alberta, which demonstrates that health inequities by SES exist in countries with single‐payer health care systems. Further research is needed to better understand the underlying causes and to develop strategies to mitigate these disparities.

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Effects of socioeconomic status on cancer patient survival: counterfactual event-based mediation analysis

Cited by 8 publications

References 31 publications

The Impact of Neighborhood Deprivation on the Survival Rates of Patients with Cancer in Korea

The Impact of Neighborhood Deprivation on the Survival Rates of Patients with Cancer in Korea

How to use the Surveillance, Epidemiology, and End Results (SEER) data: research design and methodology

The association between neighborhood‐level income and cancer stage at diagnosis and survival in Alberta

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