J Korean Med Sci.  2017 Dec;32(12):1974-1983. 10.3346/jkms.2017.32.12.1974.

Disparities by Age, Sex, Tumor Stage, Diagnosis Path, and Area-level Socioeconomic Status in Survival Time for Major Cancers: Results from the Busan Cancer Registry

• Kwak M
• Kim C

• KMID: 2396374
• DOI: http://doi.org/10.3346/jkms.2017.32.12.1974

Abstract

Our goal was to examine the effect of area-level deprivation on patient survival time for seven major cancers "” stomach, colon, liver, lung, breast, cervix, and thyroid cancer. Data on 10,902 subjects who were diagnosed with major cancers from 2010 and 2011 in Busan were collected regarding the survival time along with several important prognostic factors and an area-level deprivation index was constructed from education, income, unemployment, and welfare assistance, to assess the comprehensive area-level socioeconomic status. A multilevel Cox proportional hazard model was used to investigate the effects of multiple risk factors such as gender, age, tumor stage, diagnosis path, and the area-level deprivation. After adjusting for risk factors the area-level deprivation index was found to be significant in associating with higher hazard rate for several cancers. Estimated hazard ratios (95% CI) were 1.08 (0.99-1.18), 1.23 (1.12-1.36), 1.36 (1.21-1.53) for the second, the third, and the fourth quartile of deprivation index groups, respectively, when compared to the least deprived group. When compared with the least deprived group, the more deprived group showed significant decrease in survival time for major cancers. This novel finding may contribute to the literature regarding the association of area-level socioeconomic status and highlight the importance of careful monitoring of socioeconomic characteristics for cancer prevention and care services.

Keyword

Cancer; Survival Time; Area-level Deprivation; Hazard Ratio; Risk Factors

MeSH Terms

Breast
Busan*
Cervix Uteri
Colon
Diagnosis*
Education
Female
Humans
Liver
Lung
Proportional Hazards Models
Risk Factors
Social Class*
Stomach
Thyroid Neoplasms
Unemployment

Figure

• 

  Fig. 1 Multivariate-adjusted HRs and 95% CIs for cancer-specific survival time from a stratified analysis by tumor stage. HR for one unit change of area-level deprivation as continuous scale was presented. Larger value of area-level deprivation index corresponds to more deprivation. Black circles represent the estimated HR and solid horizontal lines represent the 95% CI. HR = hazard ratio, CI = confidence interval.

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