Low neighborhood socioeconomic status is associated with poor outcomes in young adults with colorectal cancer
The incidence of early-onset colorectal cancer has increased markedly over the past decade. Although established for older adults, there are limited data on socioeconomic and racial disparities in screening, treatment, and outcomes in this distinct group. Adults with primary colorectal cancer diagno...
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| Veröffentlicht in: | Surgery 2024-09, Vol.176 (3), p.626-632 |
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| creator | Ko, Tomohiro M. Laraia, Kayla N. Alexander, H. Richard Ecker, Brett L. Grandhi, Miral S. Kennedy, Timothy J. In, Haejin Langan, Russell C. Pitt, Henry A. Stroup, Antoinette M. Eskander, Mariam F. |
| description | The incidence of early-onset colorectal cancer has increased markedly over the past decade. Although established for older adults, there are limited data on socioeconomic and racial disparities in screening, treatment, and outcomes in this distinct group.
Adults with primary colorectal cancer diagnosed at age |
| doi_str_mv | 10.1016/j.surg.2024.05.031 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3076764270</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0039606024003313</els_id><sourcerecordid>3076764270</sourcerecordid><originalsourceid>FETCH-LOGICAL-c237t-b0091d54dc88177eb559c12e7b00251b6ecdb60c6122497dceb2a07a8040785c3</originalsourceid><addsrcrecordid>eNp9kMFu1DAQhi0EotvCC3BAPnJJGDuJnUhcUFWg0kpc4Gw59nTXqySz2A5V3x5HWzhymsN8_6-Zj7F3AmoBQn081WmNh1qCbGvoamjEC7YTXSMr3Sjxku0AmqFSoOCKXad0AoChFf1rdtX0g5ZaDTs27-mRLxgOx5HikcjzRC4QOlpoDo6nbPOaeEjcpm1jM3r-GPKRn4kipzU7mrEAC3-idTlw69cppwviaKKILtuJO7s4jG_Yqwc7JXz7PG_Yzy93P26_VfvvX-9vP-8rJxudq7EcKnzXetf3Qmscu25wQqIuC9mJUaHzowKnhJTtoL3DUVrQtocWdN-55oZ9uPSeI_1aMWUzh-RwmuyCtCbTgFZatVJDQeUFdZFSivhgzjHMNj4ZAWbTbE5m02w2zQY6UzSX0Pvn_nWc0f-L_PVagE8XAMuXvwNGk1zAosCHTYjxFP7X_wcg5pB3</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3076764270</pqid></control><display><type>article</type><title>Low neighborhood socioeconomic status is associated with poor outcomes in young adults with colorectal cancer</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Ko, Tomohiro M. ; Laraia, Kayla N. ; Alexander, H. Richard ; Ecker, Brett L. ; Grandhi, Miral S. ; Kennedy, Timothy J. ; In, Haejin ; Langan, Russell C. ; Pitt, Henry A. ; Stroup, Antoinette M. ; Eskander, Mariam F.</creator><creatorcontrib>Ko, Tomohiro M. ; Laraia, Kayla N. ; Alexander, H. Richard ; Ecker, Brett L. ; Grandhi, Miral S. ; Kennedy, Timothy J. ; In, Haejin ; Langan, Russell C. ; Pitt, Henry A. ; Stroup, Antoinette M. ; Eskander, Mariam F.</creatorcontrib><description>The incidence of early-onset colorectal cancer has increased markedly over the past decade. Although established for older adults, there are limited data on socioeconomic and racial disparities in screening, treatment, and outcomes in this distinct group.
Adults with primary colorectal cancer diagnosed at age <50 were identified from the Surveillance, Epidemiology, and End Results database. The exposure of interest was neighborhood socioeconomic status based on the Yost Index, a census-tract level composite score of neighborhood economic health. Univariate analysis was performed with χ2 analyses. Logistic regression models were created to evaluate the association of neighborhood socioeconomic status (Yost Index quintile) with metastasis at presentation and surgical intervention. Kaplan–Meier and Cox proportional hazards models were created.
In total, 45,660 early-onset colorectal cancer patients were identified; 16.8% (7,679) were in the lowest quintile of neighborhood socioeconomic status. Patients with the lowest neighborhood socioeconomic status were 1.13 times (95% confidence interval 1.06–1.21) more likely to present with metastases and had lower survival (hazard ratio 1.45, 95% confidence interval 1.37–1.53) compared to those with the highest neighborhood socioeconomic status. Non-Hispanic Black patients were more likely to present with metastatic disease (odds ratio 1.11, 95% confidence interval 1.05–1.19), less likely to undergo surgery for localized or regional disease (odds ratio 0.48, 95% confidence interval 0.43–0.53), and had lower survival (hazard ratio 1.21, 95% confidence interval 1.15–1.27) than non-Hispanic White patients.
Socioeconomic and racial disparities in early-onset colorectal cancer span diagnosis, treatment, and survival. As the disease burden of early-age onset colorectal cancer increases, interventions to boost early diagnosis and access to surgery are necessary to improve survival among minorities and patients with low neighborhood socioeconomic status.</description><identifier>ISSN: 0039-6060</identifier><identifier>ISSN: 1532-7361</identifier><identifier>EISSN: 1532-7361</identifier><identifier>DOI: 10.1016/j.surg.2024.05.031</identifier><identifier>PMID: 38972769</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Colorectal Neoplasms - economics ; Colorectal Neoplasms - mortality ; Colorectal Neoplasms - pathology ; Colorectal Neoplasms - therapy ; Female ; Healthcare Disparities - economics ; Healthcare Disparities - statistics & numerical data ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neighborhood Characteristics ; Proportional Hazards Models ; Residence Characteristics - statistics & numerical data ; Retrospective Studies ; SEER Program ; Social Class ; United States - epidemiology ; Young Adult</subject><ispartof>Surgery, 2024-09, Vol.176 (3), p.626-632</ispartof><rights>2024</rights><rights>Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c237t-b0091d54dc88177eb559c12e7b00251b6ecdb60c6122497dceb2a07a8040785c3</cites><orcidid>0000-0001-8984-3458</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0039606024003313$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38972769$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ko, Tomohiro M.</creatorcontrib><creatorcontrib>Laraia, Kayla N.</creatorcontrib><creatorcontrib>Alexander, H. Richard</creatorcontrib><creatorcontrib>Ecker, Brett L.</creatorcontrib><creatorcontrib>Grandhi, Miral S.</creatorcontrib><creatorcontrib>Kennedy, Timothy J.</creatorcontrib><creatorcontrib>In, Haejin</creatorcontrib><creatorcontrib>Langan, Russell C.</creatorcontrib><creatorcontrib>Pitt, Henry A.</creatorcontrib><creatorcontrib>Stroup, Antoinette M.</creatorcontrib><creatorcontrib>Eskander, Mariam F.</creatorcontrib><title>Low neighborhood socioeconomic status is associated with poor outcomes in young adults with colorectal cancer</title><title>Surgery</title><addtitle>Surgery</addtitle><description>The incidence of early-onset colorectal cancer has increased markedly over the past decade. Although established for older adults, there are limited data on socioeconomic and racial disparities in screening, treatment, and outcomes in this distinct group.
Adults with primary colorectal cancer diagnosed at age <50 were identified from the Surveillance, Epidemiology, and End Results database. The exposure of interest was neighborhood socioeconomic status based on the Yost Index, a census-tract level composite score of neighborhood economic health. Univariate analysis was performed with χ2 analyses. Logistic regression models were created to evaluate the association of neighborhood socioeconomic status (Yost Index quintile) with metastasis at presentation and surgical intervention. Kaplan–Meier and Cox proportional hazards models were created.
In total, 45,660 early-onset colorectal cancer patients were identified; 16.8% (7,679) were in the lowest quintile of neighborhood socioeconomic status. Patients with the lowest neighborhood socioeconomic status were 1.13 times (95% confidence interval 1.06–1.21) more likely to present with metastases and had lower survival (hazard ratio 1.45, 95% confidence interval 1.37–1.53) compared to those with the highest neighborhood socioeconomic status. Non-Hispanic Black patients were more likely to present with metastatic disease (odds ratio 1.11, 95% confidence interval 1.05–1.19), less likely to undergo surgery for localized or regional disease (odds ratio 0.48, 95% confidence interval 0.43–0.53), and had lower survival (hazard ratio 1.21, 95% confidence interval 1.15–1.27) than non-Hispanic White patients.
Socioeconomic and racial disparities in early-onset colorectal cancer span diagnosis, treatment, and survival. As the disease burden of early-age onset colorectal cancer increases, interventions to boost early diagnosis and access to surgery are necessary to improve survival among minorities and patients with low neighborhood socioeconomic status.</description><subject>Adult</subject><subject>Colorectal Neoplasms - economics</subject><subject>Colorectal Neoplasms - mortality</subject><subject>Colorectal Neoplasms - pathology</subject><subject>Colorectal Neoplasms - therapy</subject><subject>Female</subject><subject>Healthcare Disparities - economics</subject><subject>Healthcare Disparities - statistics & numerical data</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neighborhood Characteristics</subject><subject>Proportional Hazards Models</subject><subject>Residence Characteristics - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>SEER Program</subject><subject>Social Class</subject><subject>United States - epidemiology</subject><subject>Young Adult</subject><issn>0039-6060</issn><issn>1532-7361</issn><issn>1532-7361</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFu1DAQhi0EotvCC3BAPnJJGDuJnUhcUFWg0kpc4Gw59nTXqySz2A5V3x5HWzhymsN8_6-Zj7F3AmoBQn081WmNh1qCbGvoamjEC7YTXSMr3Sjxku0AmqFSoOCKXad0AoChFf1rdtX0g5ZaDTs27-mRLxgOx5HikcjzRC4QOlpoDo6nbPOaeEjcpm1jM3r-GPKRn4kipzU7mrEAC3-idTlw69cppwviaKKILtuJO7s4jG_Yqwc7JXz7PG_Yzy93P26_VfvvX-9vP-8rJxudq7EcKnzXetf3Qmscu25wQqIuC9mJUaHzowKnhJTtoL3DUVrQtocWdN-55oZ9uPSeI_1aMWUzh-RwmuyCtCbTgFZatVJDQeUFdZFSivhgzjHMNj4ZAWbTbE5m02w2zQY6UzSX0Pvn_nWc0f-L_PVagE8XAMuXvwNGk1zAosCHTYjxFP7X_wcg5pB3</recordid><startdate>202409</startdate><enddate>202409</enddate><creator>Ko, Tomohiro M.</creator><creator>Laraia, Kayla N.</creator><creator>Alexander, H. Richard</creator><creator>Ecker, Brett L.</creator><creator>Grandhi, Miral S.</creator><creator>Kennedy, Timothy J.</creator><creator>In, Haejin</creator><creator>Langan, Russell C.</creator><creator>Pitt, Henry A.</creator><creator>Stroup, Antoinette M.</creator><creator>Eskander, Mariam F.</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8984-3458</orcidid></search><sort><creationdate>202409</creationdate><title>Low neighborhood socioeconomic status is associated with poor outcomes in young adults with colorectal cancer</title><author>Ko, Tomohiro M. ; Laraia, Kayla N. ; Alexander, H. Richard ; Ecker, Brett L. ; Grandhi, Miral S. ; Kennedy, Timothy J. ; In, Haejin ; Langan, Russell C. ; Pitt, Henry A. ; Stroup, Antoinette M. ; Eskander, Mariam F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c237t-b0091d54dc88177eb559c12e7b00251b6ecdb60c6122497dceb2a07a8040785c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Colorectal Neoplasms - economics</topic><topic>Colorectal Neoplasms - mortality</topic><topic>Colorectal Neoplasms - pathology</topic><topic>Colorectal Neoplasms - therapy</topic><topic>Female</topic><topic>Healthcare Disparities - economics</topic><topic>Healthcare Disparities - statistics & numerical data</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neighborhood Characteristics</topic><topic>Proportional Hazards Models</topic><topic>Residence Characteristics - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>SEER Program</topic><topic>Social Class</topic><topic>United States - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ko, Tomohiro M.</creatorcontrib><creatorcontrib>Laraia, Kayla N.</creatorcontrib><creatorcontrib>Alexander, H. Richard</creatorcontrib><creatorcontrib>Ecker, Brett L.</creatorcontrib><creatorcontrib>Grandhi, Miral S.</creatorcontrib><creatorcontrib>Kennedy, Timothy J.</creatorcontrib><creatorcontrib>In, Haejin</creatorcontrib><creatorcontrib>Langan, Russell C.</creatorcontrib><creatorcontrib>Pitt, Henry A.</creatorcontrib><creatorcontrib>Stroup, Antoinette M.</creatorcontrib><creatorcontrib>Eskander, Mariam F.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ko, Tomohiro M.</au><au>Laraia, Kayla N.</au><au>Alexander, H. Richard</au><au>Ecker, Brett L.</au><au>Grandhi, Miral S.</au><au>Kennedy, Timothy J.</au><au>In, Haejin</au><au>Langan, Russell C.</au><au>Pitt, Henry A.</au><au>Stroup, Antoinette M.</au><au>Eskander, Mariam F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Low neighborhood socioeconomic status is associated with poor outcomes in young adults with colorectal cancer</atitle><jtitle>Surgery</jtitle><addtitle>Surgery</addtitle><date>2024-09</date><risdate>2024</risdate><volume>176</volume><issue>3</issue><spage>626</spage><epage>632</epage><pages>626-632</pages><issn>0039-6060</issn><issn>1532-7361</issn><eissn>1532-7361</eissn><abstract>The incidence of early-onset colorectal cancer has increased markedly over the past decade. Although established for older adults, there are limited data on socioeconomic and racial disparities in screening, treatment, and outcomes in this distinct group.
Adults with primary colorectal cancer diagnosed at age <50 were identified from the Surveillance, Epidemiology, and End Results database. The exposure of interest was neighborhood socioeconomic status based on the Yost Index, a census-tract level composite score of neighborhood economic health. Univariate analysis was performed with χ2 analyses. Logistic regression models were created to evaluate the association of neighborhood socioeconomic status (Yost Index quintile) with metastasis at presentation and surgical intervention. Kaplan–Meier and Cox proportional hazards models were created.
In total, 45,660 early-onset colorectal cancer patients were identified; 16.8% (7,679) were in the lowest quintile of neighborhood socioeconomic status. Patients with the lowest neighborhood socioeconomic status were 1.13 times (95% confidence interval 1.06–1.21) more likely to present with metastases and had lower survival (hazard ratio 1.45, 95% confidence interval 1.37–1.53) compared to those with the highest neighborhood socioeconomic status. Non-Hispanic Black patients were more likely to present with metastatic disease (odds ratio 1.11, 95% confidence interval 1.05–1.19), less likely to undergo surgery for localized or regional disease (odds ratio 0.48, 95% confidence interval 0.43–0.53), and had lower survival (hazard ratio 1.21, 95% confidence interval 1.15–1.27) than non-Hispanic White patients.
Socioeconomic and racial disparities in early-onset colorectal cancer span diagnosis, treatment, and survival. As the disease burden of early-age onset colorectal cancer increases, interventions to boost early diagnosis and access to surgery are necessary to improve survival among minorities and patients with low neighborhood socioeconomic status.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38972769</pmid><doi>10.1016/j.surg.2024.05.031</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-8984-3458</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Colorectal Neoplasms - economics Colorectal Neoplasms - mortality Colorectal Neoplasms - pathology Colorectal Neoplasms - therapy Female Healthcare Disparities - economics Healthcare Disparities - statistics & numerical data Humans Kaplan-Meier Estimate Male Middle Aged Neighborhood Characteristics Proportional Hazards Models Residence Characteristics - statistics & numerical data Retrospective Studies SEER Program Social Class United States - epidemiology Young Adult |
| title | Low neighborhood socioeconomic status is associated with poor outcomes in young adults with colorectal cancer |
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