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Socio‐economic disadvantage and demographics as factors in stage of colorectal cancer presentation and survival
Author(s) -
Barclay Karen L.,
Goh PaulJon,
Jackson Terri J.
Publication year - 2015
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12709
Subject(s) - medicine , stage (stratigraphy) , presentation (obstetrics) , cancer , disadvantage , colorectal cancer , demography , multivariate analysis , t stage , surgery , paleontology , sociology , political science , law , biology
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 .