Influence of socioeconomic environment on survival in patients diagnosed with esophageal cancer: a population-based study

Abstract

The influence of social environment on survival in patients with cancer has been demonstrated in many studies, subjects living in the most deprived areas having a poorer prognosis. Geographic remoteness and limited access to specialized care centers are often associated with socioeconomic deprivation. The aim was to assess the influence of social environment and geographic remoteness on the relative survival of patients diagnosed with esophageal cancer between 1997 and 2004 in the department of Calvados in France. The study population, which was provided by the Calvados digestive cancer registry, included 629 patients. Relative survival was used to estimate the influence of social environment and geographic remoteness on patient survival. Five-year survival rates were 14.1%, 15.1%, 11.8%, 8.8%, and 11.4%, respectively, for patients living in the least to the most deprived areas (P= 0.39). The influence of social environment was significant after adjustment for clinical variables, patients living in the most deprived areas having the worst survival. These discrepancies cannot totally be explained by differences in access to care, cancer extension, or morphology at diagnosis. No association was observed between distance to the nearest cancer center and survival. Social environment appears to induce disparities among patients diagnosed with esophageal cancer, with a worse prognosis for patients living in the most deprived areas.

Socioeconomic deprivation and cancer survival in Germany: An ecological analysis in 200 districts in Germany

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Impact of socioeconomic status on survival for patients with anal cancer

“…Beyond racial disparities, socioeconomic status (SES), as measured by income level or degree of education, also recently was associated with multiple poor health outcomes, including diabetes, cardiovascular disease, and cancer . Population cohort studies in lung and esophageal cancers have suggested that one's social environment, as defined by area‐based socioeconomic measures, may be associated with worse survival outcomes, possibly due to poor screening or receipt of therapy . Such class disparities ultimately may mitigate improvements in outcomes, and warrant further evaluation to identify root causes of poor health and inequalities.…”

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