Socio‐economic disadvantage and demographics as factors in stage of colorectal cancer presentation and survival

Background Colorectal cancer ( CRC ) is common, and early diagnosis improves outcome. Overseas studies have suggested that low socio‐economic status ( SES ) is related to advanced cancer stage at presentation and reduced survival. The situation in A ustralia is unclear. This study examines the effect of demographic and SES on CRC stage at presentation and survival in a single tertiary centre. Methods Patients undergoing surgical resection for CRC (1 January 2005 to 31 December 2010) were identified, and socio‐demographic and histopathological information obtained. Four socio‐economic indices using 2006 A ustralian C ensus data were assigned by residential postcode. Factors contributing to tumour ( T ) and American Joint Committee on Cancer ( AJCC ) stage at presentation and survival were assessed. Results Five hundred and fifty‐seven patients were included. Results did not support a relationship between SES and either advanced stage at presentation or survival. Only one index (economic resources) was related to a more advanced T stage at presentation ( P = 0.011); none were related to AJCC stage or survival. No significant relationship was found between an individual's country of birth, language spoken, private insurance or employment status and presenting with a later T or AJCC stage. Age, AJCC and T stage at diagnosis and emergency presentation significantly affected survival on multivariate analysis. Conclusion SES and most demographic factors did not appear to significantly influence CRC stage at presentation and outcome. A focus on obtaining equivalent access to health care both nationally and internationally could prove beneficial in improving outcomes for CRC .