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Posted on Mar 23, 2018, 2 p.m.
Patients living in low median household income areas were linked with increased risk of early death in a study of patients with anal cancer, with findings suggesting that socioeconomic inequalities may affect patient outcomes, especially in treatable tumors such as anal cancer, as published in CANCER.
In the USA squamous cell carcinoma of the anus is responsible for 8,200 new cancer cases each year and more than 1,000 cancer related deaths. Incidence of anal cancer has increased notably in recent decades, increases may be related to known risk factors combined with changing trends in sexual behavior. Chances of survival and cure have been improved by advances in treatment of anal cancer, however these benefits may not be shared uniformly among patients who reside in disparate socioeconomic status.
Researchers examined whether area based median household income can predict survival rate of patients with squamous cell carcinoma of the anus. Analysis included 9,550 patients listed in the US Surveillance Epidemiology and End Results registry. Census tract median household income level defined socioeconomic status, which was then divided into quintiles.
It was found that worse cancer specific survival rates and worse overall survival rates were linked to patients living in areas of low median household income than those compared to in the highest household income areas. Risk of death was 32% for the lowest income, 31%, 19%, and 16% to the highest income levels, higher for patients as compared to those living in the very highest quintile of household income. Risk for deaths only due to cancer increased the risks from 34% from the lowest income household down to 22% from highest household incomes. Other factors such as male gender, unmarried status, older age, race, earlier year of diagnosis, higher education, and later stage were also associated with worse cancer specific survival rates. Household income was not associated with likelihood of initiating radiation therapy.
Findings show that in the USA patients living in areas of poverty with squamous cell carcinoma of the anus have a worse survival rate than those who reside in affluent areas, even after taking into consideration factors such as stage, race, and age. Squamous cell carcinoma of the anus is often curable which makes these findings even more disheartening, as in light of tremendous resources available within the healthcare system poverty should not determine cancer outcomes, or any for that matter, as the ultimate goal should be that all patients receive the same high quality care regardless of their zip code.
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