Contribution of income-related inequality and healthcare utilisation to survival in cancers of the lung, liver, stomach and colon
ObjectivesTo examine differences in the survival rates of cancer patients according to socioeconomic status, focusing on the role of the degree of healthcare utilisation by the patient.MethodsAn observational follow-up study was done for 261 lung cancer, 259 liver cancer, 268 stomach cancer and 270...
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| Veröffentlicht in: | Journal of epidemiology and community health (1979) 2012-01, Vol.66 (1), p.37-40 |
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| creator | Yim, Jun Hwang, Seung-sik Yoo, Keun-young Kim, Chang-yup |
| description | ObjectivesTo examine differences in the survival rates of cancer patients according to socioeconomic status, focusing on the role of the degree of healthcare utilisation by the patient.MethodsAn observational follow-up study was done for 261 lung cancer, 259 liver cancer, 268 stomach cancer and 270 colon cancer patients, diagnosed during 1999–2002. Income status and healthcare utilisation were assessed with National Health Insurance (NHI) data; survival during 1999–2002 was identified by death certificate. HRs and 95% CI were derived from Cox proportional hazards regression.Results and ConclusionsThe HRs for low income status are larger for colon cancer (2.37, 95% CI 1.17 to 4.80), followed by stomach (1.67, 95% CI 1.01 to 2.78), liver (1.57, 95% CI 1.03 to 2.39) and lung cancers (1.46, 95% CI 0.99 to 2.14). In the model including the variable of healthcare utilisation, colon and stomach cancers exhibited a lower HR in the moderate healthcare utilisation groups (0.40, 95% CI 0.21 to 0.76 in colon; 0.59, 95% CI 0.37 to 0.96 in stomach), whereas for liver cancer, the high utilisation group exhibited a higher hazard (1.72, 95% CI 1.07 to 2.75). A lower income status is independently related to a shorter survival time in cancer patients, especially in less fatal cancers. Healthcare utilisation independently affects the likelihood of survival from colon and stomach cancers, implying that a moderate degree of healthcare utilisation contributes to a longer survival time. |
| doi_str_mv | 10.1136/jech.2009.104554 |
| format | Article |
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Income status and healthcare utilisation were assessed with National Health Insurance (NHI) data; survival during 1999–2002 was identified by death certificate. HRs and 95% CI were derived from Cox proportional hazards regression.Results and ConclusionsThe HRs for low income status are larger for colon cancer (2.37, 95% CI 1.17 to 4.80), followed by stomach (1.67, 95% CI 1.01 to 2.78), liver (1.57, 95% CI 1.03 to 2.39) and lung cancers (1.46, 95% CI 0.99 to 2.14). In the model including the variable of healthcare utilisation, colon and stomach cancers exhibited a lower HR in the moderate healthcare utilisation groups (0.40, 95% CI 0.21 to 0.76 in colon; 0.59, 95% CI 0.37 to 0.96 in stomach), whereas for liver cancer, the high utilisation group exhibited a higher hazard (1.72, 95% CI 1.07 to 2.75). A lower income status is independently related to a shorter survival time in cancer patients, especially in less fatal cancers. Healthcare utilisation independently affects the likelihood of survival from colon and stomach cancers, implying that a moderate degree of healthcare utilisation contributes to a longer survival time.</description><identifier>ISSN: 0143-005X</identifier><identifier>EISSN: 1470-2738</identifier><identifier>DOI: 10.1136/jech.2009.104554</identifier><identifier>PMID: 20961877</identifier><identifier>CODEN: JECHDR</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd</publisher><subject>Biological and medical sciences ; Cancer ; Colorectal cancer ; Colorectal Neoplasms - epidemiology ; Colorectal Neoplasms - mortality ; Confidence Intervals ; Family medical history ; Female ; Gastric cancer ; General aspects ; Health care ; Health care industry ; Health Services - statistics & numerical data ; Health Services - utilization ; Health Status Disparities ; heath-care utilisation ; Hospitals ; Humans ; Income ; Income - statistics & numerical data ; Income inequality ; Kaplan-Meier Estimate ; Korea ; Korea - epidemiology ; Liver ; Liver cancer ; Liver Neoplasms - epidemiology ; Liver Neoplasms - mortality ; Lung cancer ; Lung neoplasms ; Lung Neoplasms - epidemiology ; Lung Neoplasms - mortality ; Male ; Medicaid ; Medical records ; Medical sciences ; Miscellaneous ; Morphology ; Mortality ; Multivariate analysis ; National health insurance ; Population ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Quality ; Registries ; Research report ; Risk Assessment ; Social Class ; social inequalities ; Socioeconomic factors ; Socioeconomic status ; Socioeconomics ; Stomach ; Stomach cancer ; Stomach Neoplasms - epidemiology ; Stomach Neoplasms - mortality ; Survival ; Survivors - statistics & numerical data ; Tumors</subject><ispartof>Journal of epidemiology and community health (1979), 2012-01, Vol.66 (1), p.37-40</ispartof><rights>2011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Copyright © 2012 BMJ Publishing Group</rights><rights>2015 INIST-CNRS</rights><rights>Copyright: 2011 (c) 2011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b485t-4b436eaebcc83d39187bc9cbe0849c97cd49bb8353e5c1249ab6e43b566ad8813</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jech.bmj.com/content/66/1/37.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://jech.bmj.com/content/66/1/37.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,780,784,803,3196,4024,23571,27923,27924,27925,58017,58250,77600,77631</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25290091$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20961877$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yim, Jun</creatorcontrib><creatorcontrib>Hwang, Seung-sik</creatorcontrib><creatorcontrib>Yoo, Keun-young</creatorcontrib><creatorcontrib>Kim, Chang-yup</creatorcontrib><title>Contribution of income-related inequality and healthcare utilisation to survival in cancers of the lung, liver, stomach and colon</title><title>Journal of epidemiology and community health (1979)</title><addtitle>J Epidemiol Community Health</addtitle><description>ObjectivesTo examine differences in the survival rates of cancer patients according to socioeconomic status, focusing on the role of the degree of healthcare utilisation by the patient.MethodsAn observational follow-up study was done for 261 lung cancer, 259 liver cancer, 268 stomach cancer and 270 colon cancer patients, diagnosed during 1999–2002. Income status and healthcare utilisation were assessed with National Health Insurance (NHI) data; survival during 1999–2002 was identified by death certificate. HRs and 95% CI were derived from Cox proportional hazards regression.Results and ConclusionsThe HRs for low income status are larger for colon cancer (2.37, 95% CI 1.17 to 4.80), followed by stomach (1.67, 95% CI 1.01 to 2.78), liver (1.57, 95% CI 1.03 to 2.39) and lung cancers (1.46, 95% CI 0.99 to 2.14). In the model including the variable of healthcare utilisation, colon and stomach cancers exhibited a lower HR in the moderate healthcare utilisation groups (0.40, 95% CI 0.21 to 0.76 in colon; 0.59, 95% CI 0.37 to 0.96 in stomach), whereas for liver cancer, the high utilisation group exhibited a higher hazard (1.72, 95% CI 1.07 to 2.75). A lower income status is independently related to a shorter survival time in cancer patients, especially in less fatal cancers. Healthcare utilisation independently affects the likelihood of survival from colon and stomach cancers, implying that a moderate degree of healthcare utilisation contributes to a longer survival time.</description><subject>Biological and medical sciences</subject><subject>Cancer</subject><subject>Colorectal cancer</subject><subject>Colorectal Neoplasms - epidemiology</subject><subject>Colorectal Neoplasms - mortality</subject><subject>Confidence Intervals</subject><subject>Family medical history</subject><subject>Female</subject><subject>Gastric cancer</subject><subject>General aspects</subject><subject>Health care</subject><subject>Health care industry</subject><subject>Health Services - statistics & numerical data</subject><subject>Health Services - utilization</subject><subject>Health Status Disparities</subject><subject>heath-care utilisation</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Income</subject><subject>Income - statistics & numerical data</subject><subject>Income inequality</subject><subject>Kaplan-Meier Estimate</subject><subject>Korea</subject><subject>Korea - epidemiology</subject><subject>Liver</subject><subject>Liver cancer</subject><subject>Liver Neoplasms - epidemiology</subject><subject>Liver Neoplasms - mortality</subject><subject>Lung cancer</subject><subject>Lung neoplasms</subject><subject>Lung Neoplasms - epidemiology</subject><subject>Lung Neoplasms - mortality</subject><subject>Male</subject><subject>Medicaid</subject><subject>Medical records</subject><subject>Medical sciences</subject><subject>Miscellaneous</subject><subject>Morphology</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>National health insurance</subject><subject>Population</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Quality</subject><subject>Registries</subject><subject>Research report</subject><subject>Risk Assessment</subject><subject>Social Class</subject><subject>social inequalities</subject><subject>Socioeconomic factors</subject><subject>Socioeconomic status</subject><subject>Socioeconomics</subject><subject>Stomach</subject><subject>Stomach cancer</subject><subject>Stomach Neoplasms - epidemiology</subject><subject>Stomach Neoplasms - mortality</subject><subject>Survival</subject><subject>Survivors - statistics & numerical data</subject><subject>Tumors</subject><issn>0143-005X</issn><issn>1470-2738</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkc1v1DAQxSMEokvhzgUUCSGQaBY7tmP7iFblQ6qWA1Bxs2xnlvXixK2drNoj_zlOs7QSBzjZ1vze88y8oniK0RJj0rzdgd0ua4TkEiPKGL1XLDDlqKo5EfeLBcKUVAix70fFo5R2KF95LR8WRzWSDRacL4pfq9AP0ZlxcKEvw6Z0vQ0dVBG8HqDNT7gctXfDdan7ttyC9sPW6ghlVniX9I1uCGUa497ttc-K0ureQkyT3bCF0o_9j5PSuz3EkzINodN2e-Nmgw_94-LBRvsETw7ncfHt_enX1cfq7POHT6t3Z5Whgg0VNZQ0oMFYK0hLZG7fWGkNIEGlldy2VBojCCPALK6p1KYBSgxrGt0Kgclx8Wr2vYjhcoQ0qM4lC97rHsKYlESCEymQzOTrf5K4ZlwwTuVk-uIvdBfG2Oc5FOZc1vlfRjOFZsrGkFKEjbqIrtPxWmGkpiDVFKSaglRzkFny_GA8mg7aW8Gf5DLw8gDoZLXfxLxzl-44VstsN3X4bOZ2efPxrk4QxwJNPtVcd2mAq9u6jj9Vwwlnan2-UmS9FvQcf1Eo829m3nS7_4_xG6zIzYo</recordid><startdate>201201</startdate><enddate>201201</enddate><creator>Yim, Jun</creator><creator>Hwang, Seung-sik</creator><creator>Yoo, Keun-young</creator><creator>Kim, Chang-yup</creator><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</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>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7T2</scope><scope>7U2</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>201201</creationdate><title>Contribution of income-related inequality and healthcare utilisation to survival in cancers of the lung, liver, stomach and colon</title><author>Yim, Jun ; Hwang, Seung-sik ; Yoo, Keun-young ; Kim, Chang-yup</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b485t-4b436eaebcc83d39187bc9cbe0849c97cd49bb8353e5c1249ab6e43b566ad8813</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Biological and medical sciences</topic><topic>Cancer</topic><topic>Colorectal cancer</topic><topic>Colorectal Neoplasms - epidemiology</topic><topic>Colorectal Neoplasms - mortality</topic><topic>Confidence Intervals</topic><topic>Family medical history</topic><topic>Female</topic><topic>Gastric cancer</topic><topic>General aspects</topic><topic>Health care</topic><topic>Health care industry</topic><topic>Health Services - statistics & numerical data</topic><topic>Health Services - utilization</topic><topic>Health Status Disparities</topic><topic>heath-care utilisation</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Income</topic><topic>Income - statistics & numerical data</topic><topic>Income inequality</topic><topic>Kaplan-Meier Estimate</topic><topic>Korea</topic><topic>Korea - epidemiology</topic><topic>Liver</topic><topic>Liver cancer</topic><topic>Liver Neoplasms - epidemiology</topic><topic>Liver Neoplasms - mortality</topic><topic>Lung cancer</topic><topic>Lung neoplasms</topic><topic>Lung Neoplasms - epidemiology</topic><topic>Lung Neoplasms - mortality</topic><topic>Male</topic><topic>Medicaid</topic><topic>Medical records</topic><topic>Medical sciences</topic><topic>Miscellaneous</topic><topic>Morphology</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>National health insurance</topic><topic>Population</topic><topic>Public health. 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Hygiene-occupational medicine</topic><topic>Quality</topic><topic>Registries</topic><topic>Research report</topic><topic>Risk Assessment</topic><topic>Social Class</topic><topic>social inequalities</topic><topic>Socioeconomic factors</topic><topic>Socioeconomic status</topic><topic>Socioeconomics</topic><topic>Stomach</topic><topic>Stomach cancer</topic><topic>Stomach Neoplasms - epidemiology</topic><topic>Stomach Neoplasms - mortality</topic><topic>Survival</topic><topic>Survivors - statistics & numerical data</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yim, Jun</creatorcontrib><creatorcontrib>Hwang, Seung-sik</creatorcontrib><creatorcontrib>Yoo, Keun-young</creatorcontrib><creatorcontrib>Kim, Chang-yup</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of epidemiology and community health (1979)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yim, Jun</au><au>Hwang, Seung-sik</au><au>Yoo, Keun-young</au><au>Kim, Chang-yup</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Contribution of income-related inequality and healthcare utilisation to survival in cancers of the lung, liver, stomach and colon</atitle><jtitle>Journal of epidemiology and community health (1979)</jtitle><addtitle>J Epidemiol Community Health</addtitle><date>2012-01</date><risdate>2012</risdate><volume>66</volume><issue>1</issue><spage>37</spage><epage>40</epage><pages>37-40</pages><issn>0143-005X</issn><eissn>1470-2738</eissn><coden>JECHDR</coden><abstract>ObjectivesTo examine differences in the survival rates of cancer patients according to socioeconomic status, focusing on the role of the degree of healthcare utilisation by the patient.MethodsAn observational follow-up study was done for 261 lung cancer, 259 liver cancer, 268 stomach cancer and 270 colon cancer patients, diagnosed during 1999–2002. Income status and healthcare utilisation were assessed with National Health Insurance (NHI) data; survival during 1999–2002 was identified by death certificate. HRs and 95% CI were derived from Cox proportional hazards regression.Results and ConclusionsThe HRs for low income status are larger for colon cancer (2.37, 95% CI 1.17 to 4.80), followed by stomach (1.67, 95% CI 1.01 to 2.78), liver (1.57, 95% CI 1.03 to 2.39) and lung cancers (1.46, 95% CI 0.99 to 2.14). In the model including the variable of healthcare utilisation, colon and stomach cancers exhibited a lower HR in the moderate healthcare utilisation groups (0.40, 95% CI 0.21 to 0.76 in colon; 0.59, 95% CI 0.37 to 0.96 in stomach), whereas for liver cancer, the high utilisation group exhibited a higher hazard (1.72, 95% CI 1.07 to 2.75). A lower income status is independently related to a shorter survival time in cancer patients, especially in less fatal cancers. Healthcare utilisation independently affects the likelihood of survival from colon and stomach cancers, implying that a moderate degree of healthcare utilisation contributes to a longer survival time.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd</pub><pmid>20961877</pmid><doi>10.1136/jech.2009.104554</doi><tpages>4</tpages></addata></record> |
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| subjects | Biological and medical sciences Cancer Colorectal cancer Colorectal Neoplasms - epidemiology Colorectal Neoplasms - mortality Confidence Intervals Family medical history Female Gastric cancer General aspects Health care Health care industry Health Services - statistics & numerical data Health Services - utilization Health Status Disparities heath-care utilisation Hospitals Humans Income Income - statistics & numerical data Income inequality Kaplan-Meier Estimate Korea Korea - epidemiology Liver Liver cancer Liver Neoplasms - epidemiology Liver Neoplasms - mortality Lung cancer Lung neoplasms Lung Neoplasms - epidemiology Lung Neoplasms - mortality Male Medicaid Medical records Medical sciences Miscellaneous Morphology Mortality Multivariate analysis National health insurance Population Public health. Hygiene Public health. Hygiene-occupational medicine Quality Registries Research report Risk Assessment Social Class social inequalities Socioeconomic factors Socioeconomic status Socioeconomics Stomach Stomach cancer Stomach Neoplasms - epidemiology Stomach Neoplasms - mortality Survival Survivors - statistics & numerical data Tumors |
| title | Contribution of income-related inequality and healthcare utilisation to survival in cancers of the lung, liver, stomach and colon |
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