Impact of socioeconomic status on survival in patients with ovarian cancer

Gardy, Joséphine; Dejardin, Olivier; Thobie, Alexandre; Eid, Yassine; Guizard, Anne‐Valérie; Launoy, Guy

doi:10.1136/ijgc-2018-000097

Cited by 9 publications

(19 citation statements)

References 28 publications

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“…, death from any cause). 6 - 8 , 11 , 14 , 16 , 17 , 20 - 26 , 33 , 37 - 39 , 41 , 42 , 45 , 46 , 48 , 50 , 51 , 53 , 55 - 58 , 62 , 63 , 70 , 72 , 78 , 79 Other studies reported both overall and cancer-specific or relative/net survival. 9 , 12 , 15 , 29 , 31 , 40 , 43 , 47 , 54 , 59 , 64 , 65 , 67 - 69 …”

Section: Resultsmentioning

confidence: 99%

“…Of the 4 studies that assessed ovarian cancer, studies from France and the US found that the observed gap in overall survival was partly explained by variations in stage at diagnosis and the treatment received. 42 , 45 A Danish study reported differential stage at diagnosis, tumor histological type, co-morbidities and health-related lifestyle behaviors as some of the explanatory factors. 23 In contrast, a study from Norway found that stage of ovarian cancer or smoking status prior to diagnosis did not contribute to overall survival gap between education groups.…”

Section: Resultsmentioning

confidence: 99%

“…All studies, except 3, had a low risk for the domain of bias due to selective reporting of results. 41 , 43 , 47 With respect to missing data, we assigned moderate risk of bias to twenty-three studies that had 10-20% of their data missing, 7 , 13 , 20 , 25 - 27 , 30 , 34 , 37 , 38 , 40 , 42 , 44 , 45 , 53 , 54 , 57 , 58 , 61 , 64 , 67 , 69 , 78 and high risk to eleven studies with more than 20% missing data, 33 , 39 , 41 , 43 , 46 , 48 , 65 , 66 , 72 , 75 , 79 regardless of whether multiple imputation was applied.…”

Section: Resultsmentioning

confidence: 99%

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Factors Explaining Socio-Economic Inequalities in Cancer Survival: A Systematic Review

2021

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Background: There is strong and well-documented evidence that socio-economic inequality in cancer survival exists within and between countries, but the underlying causes of these differences are not well understood. Methods: We systematically searched the Ovid Medline, EMBASE, and CINAHL databases up to 31 May 2020. Observational studies exploring pathways by which socio-economic position (SEP) might causally influence cancer survival were included. Results: We found 74 eligible articles published between 2005 and 2020. Cancer stage, other tumor characteristics, health-related lifestyle behaviors, co-morbidities and treatment were reported as key contributing factors, although the potential mediating effect of these factors varied across cancer sites. For common cancers such as breast and prostate cancer, stage of disease was generally cited as the primary explanatory factor, while co-morbid conditions and treatment were also reported to contribute to lower survival for more disadvantaged cases. In contrast, for colorectal cancer, most studies found that stage did not explain the observed differences in survival by SEP. For lung cancer, inequalities in survival appear to be partly explained by receipt of treatment and co-morbidities. Conclusions: Most studies compared regression models with and without adjusting for potential mediators; this method has several limitations in the presence of multiple mediators that could result in biased estimates of mediating effects and invalid conclusions. It is therefore essential that future studies apply modern methods of causal mediation analysis to accurately estimate the contribution of potential explanatory factors for these inequalities, which may translate into effective interventions to improve survival for disadvantaged cancer patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Factors Explaining Socio-Economic Inequalities in Cancer Survival: A Systematic Review

2021

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“…The potential impact of SES on cancer survival has been investigated for different tumor types in several countries, and community poverty levels have repeatedly been associated with cancer mortality [15] . Higher SES was associated with greater likelihood of surgical resection and improved survival in patients with ovarian cancer [16] . In Finland, the incidence of colon cancer in men with elementary education attainment has a steep increase [17] .…”

Section: Discussionmentioning

confidence: 91%

Ethnic, Race and Socioeconomic Disparities in Medulloblastoma: A Propensity Score-matched Analysis and Population-based Study

Zhu¹,

Zhang²,

Yu³

et al. 2021

Preprint

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Background: Medulloblastoma (MB) is the most common malignant brain tumor of childhood. Studies have shown that the link between socio-economic status, morbidity and mortality from major cancers has changed significantly over the past 50 years, and therefore the socio-economic variation in cancer incidence is dynamic. Meanwhile, Socio-economic status (SES) characteristics of patients with medulloblastoma and the influence of Socio-economic status on their prognosis have been rarely discussed. Methods: Purpose of our study was aiming to understand ethnic, gender and socioeconomic disparities in medulloblastoma by using the SEER database. Propensity score matching of cases with controls by gender was conducted at the ratio of 1:1. Multivariate cox proportional hazards model was used to assess SES impact and clinically relevant variables of medulloblastoma specific death and overall survival. Independent prognostic factors determined by multivariate analysis were used to construct nomograms. Results: 2660 patients were enrolled after the matching. Study showed unemployed (MBSD, high level vs. low level, HR = 1.334) (OS, high level vs. low level, HR = 1.311) and marital status (OS, married vs unmarried/unknow., HR = 0.706) were important factors affecting the prognosis of medulloblastoma in male. Meanwhile, median household income (MBSD, Quartile 1 vs. Quartile 3, HR = 1.029) (OS, Quartile 1 vs. Quartile 2, HR = 1.809) (OS, Quartile 1 vs. Quartile 3, HR = 1.592), residence (MBSD, urban vs. rural, HR = 0.414) and insurance status (MBSD, insured vs. uninsured/unknow, HR = 0.566) (OS, insured vs. uninsured/unknow, HR = 0.573) were significant factors affecting the prognosis of medulloblastoma in female. Through the calibration plot and C-index test, our nomogram was also of predictive significance. Conclusions: The unique features of medulloblastoma have provided a scenario for the analysis of the impact of racial, ethnic, gender and socioeconomic factors. The current findings have important public health implications for achieving the goal of a healthy population. Given the known morbidity rates and the long-term psychological, financial and medical burdens that these children and their families must bear, it is critical to identify and address these gaps.

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“…Some studies use individual indices to measure the level of deprivation, such as level of income 4,[15][16][17] or education, [18][19][20] while others use an aggregate indicator generally based on the geographic area of residence. [21][22][23][24][25][26][27][28] A recent comprehensive French study estimated NS for all cancer sites according to the patients' socioeconomic environment, based on the "European deprivation index" (EDI). 29 This was the first study carried out on all cancer localizations, and using national data from all French cancer registries, covering a large population throughout France.…”

Section: Introductionmentioning

confidence: 99%

How do age and social environment affect the dynamics of death hazard and survival in patients with breast or gynecological cancer in France?

Poiseuil

Tron

Woronoff

et al. 2021

Intl Journal of Cancer

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Several studies have investigated the association between net survival (NS) and social inequalities in people with cancer, highlighting a varying influence of deprivation depending on the type of cancer studied. However, few of these studies have accounted for the effect of social inequalities over the follow‐up period, and/or according to the age of the patients. Thus, using recent and more relevant statistical models, we investigated the effect of social environment on NS in women with breast or gynecological cancer in France. The data were derived from population‐based cancer registries, and women diagnosed with breast or gynecological cancer between 2006 and 2009 were included. We used the European deprivation index (EDI), an aggregated index, to define the social environment of the women included. Multidimensional penalized splines were used to model excess mortality hazard. We observed a significant effect of the EDI on NS in women with breast cancer throughout the follow‐up period, and especially at 1.5 years of follow‐up in women with cervical cancer. Regarding corpus uteri and ovarian cancer patients, the effect of deprivation on NS was less pronounced. These results highlight the impact of social environment on NS in women with breast or gynecological cancer in France thanks to a relevant statistical approach, and identify the follow‐up periods during which the social environment may have a particular influence. These findings could help investigate targeted actions for each cancer type, particularly in the most deprived areas, at the time of diagnosis and during follow‐up.

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Impact of socioeconomic status on survival in patients with ovarian cancer

Cited by 9 publications

References 28 publications

Factors Explaining Socio-Economic Inequalities in Cancer Survival: A Systematic Review

Factors Explaining Socio-Economic Inequalities in Cancer Survival: A Systematic Review

Ethnic, Race and Socioeconomic Disparities in Medulloblastoma: A Propensity Score-matched Analysis and Population-based Study

How do age and social environment affect the dynamics of death hazard and survival in patients with breast or gynecological cancer in France?

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