Effects of Socioeconomic Status on Colon Cancer Treatment Accessibility and Survival in Toronto, Ontario, and San Francisco, California, 1996-2006

We examined the differential effects of socioeconomic status on colon cancer care and survival in Toronto, Ontario, Canada, and San Francisco, California. We analyzed registry data for colon cancer patients from Ontario (n = 930) and California (n = 1014), diagnosed between 1996 and 2000 and followe...

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Published in:American journal of public health (1971) 2011, Vol.101 (1), p.112-119
Main Authors: GOREY, Kevin M, LUGINAAH, Isaac N, BARTFAY, Emma, FUNG, Karen Y, HOLOWATY, Eric J, WRIGHT, Frances C, HAMM, Caroline, KANJEEKAL, Sindu M
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Breast cancer
Cancer therapies
Chemotherapy
Colonic Neoplasms - mortality
Colonic Neoplasms - therapy
Colorectal cancer
Disease
Early Diagnosis
Female
Gastroenterology. Liver. Pancreas. Abdomen
General aspects
Health insurance
Health Services Accessibility
Health Status Disparities
Humans
Likelihood Functions
Low income groups
Lymphatic system
Male
Medical prognosis
Medical sciences
Medical screening
Middle Aged
Miscellaneous
Missing data
Neighborhoods
Ontario - epidemiology
Poverty
Public health
Public health. Hygiene
Public health. Hygiene-occupational medicine
Radiation therapy
Research and Practice
San Francisco - epidemiology
Social Class
Socioeconomic factors
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Studies
Surgery
Survival Rate
Tumors
Waiting Lists
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cited_by cdi_FETCH-LOGICAL-c452t-e18f2cdaa952ec22a2f563afb7a92258d10dfb07306ee0fcc3d2517b971643a73
cites cdi_FETCH-LOGICAL-c452t-e18f2cdaa952ec22a2f563afb7a92258d10dfb07306ee0fcc3d2517b971643a73
container_end_page 119
container_issue 1
container_start_page 112
container_title American journal of public health (1971)
container_volume 101
creator GOREY, Kevin M
LUGINAAH, Isaac N
BARTFAY, Emma
FUNG, Karen Y
HOLOWATY, Eric J
WRIGHT, Frances C
HAMM, Caroline
KANJEEKAL, Sindu M
description We examined the differential effects of socioeconomic status on colon cancer care and survival in Toronto, Ontario, Canada, and San Francisco, California. We analyzed registry data for colon cancer patients from Ontario (n = 930) and California (n = 1014), diagnosed between 1996 and 2000 and followed until 2006, on stage, surgery, adjuvant chemotherapy, and survival. We obtained socioeconomic data for individuals' residences from population censuses. Income was directly associated with lymph node evaluation, chemotherapy, and survival in San Francisco but not in Toronto. High-income persons had better survival rates in San Francisco than in Toronto. After adjustment for stage, survival was better for low-income residents of Toronto than for those of San Francisco. Middle- to low-income patients were more likely to receive indicated chemotherapy in Toronto than in San Francisco. Socioeconomic factors appear to mediate colon cancer care in urban areas of the United States but not in Canada. Improvements are needed in screening, diagnostic investigations, and treatment access among low-income Americans.
doi_str_mv 10.2105/AJPH.2009.173112
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We analyzed registry data for colon cancer patients from Ontario (n = 930) and California (n = 1014), diagnosed between 1996 and 2000 and followed until 2006, on stage, surgery, adjuvant chemotherapy, and survival. We obtained socioeconomic data for individuals' residences from population censuses. Income was directly associated with lymph node evaluation, chemotherapy, and survival in San Francisco but not in Toronto. High-income persons had better survival rates in San Francisco than in Toronto. After adjustment for stage, survival was better for low-income residents of Toronto than for those of San Francisco. Middle- to low-income patients were more likely to receive indicated chemotherapy in Toronto than in San Francisco. Socioeconomic factors appear to mediate colon cancer care in urban areas of the United States but not in Canada. 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We analyzed registry data for colon cancer patients from Ontario (n = 930) and California (n = 1014), diagnosed between 1996 and 2000 and followed until 2006, on stage, surgery, adjuvant chemotherapy, and survival. We obtained socioeconomic data for individuals' residences from population censuses. Income was directly associated with lymph node evaluation, chemotherapy, and survival in San Francisco but not in Toronto. High-income persons had better survival rates in San Francisco than in Toronto. After adjustment for stage, survival was better for low-income residents of Toronto than for those of San Francisco. Middle- to low-income patients were more likely to receive indicated chemotherapy in Toronto than in San Francisco. Socioeconomic factors appear to mediate colon cancer care in urban areas of the United States but not in Canada. 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M. Gorey conceptualized and supervised the study and led the writing. K. Y. Fung led the analysis. All authors assisted with study design, data analysis, and interpretation and writing.</notes><notes>Peer Reviewed</notes><notes>Contributors</notes><abstract>We examined the differential effects of socioeconomic status on colon cancer care and survival in Toronto, Ontario, Canada, and San Francisco, California. We analyzed registry data for colon cancer patients from Ontario (n = 930) and California (n = 1014), diagnosed between 1996 and 2000 and followed until 2006, on stage, surgery, adjuvant chemotherapy, and survival. We obtained socioeconomic data for individuals' residences from population censuses. Income was directly associated with lymph node evaluation, chemotherapy, and survival in San Francisco but not in Toronto. High-income persons had better survival rates in San Francisco than in Toronto. After adjustment for stage, survival was better for low-income residents of Toronto than for those of San Francisco. Middle- to low-income patients were more likely to receive indicated chemotherapy in Toronto than in San Francisco. Socioeconomic factors appear to mediate colon cancer care in urban areas of the United States but not in Canada. Improvements are needed in screening, diagnostic investigations, and treatment access among low-income Americans.</abstract><cop>Washington, DC</cop><pub>American Public Health Association</pub><pmid>20299655</pmid><doi>10.2105/AJPH.2009.173112</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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identifier ISSN: 0090-0036
ispartof American journal of public health (1971), 2011, Vol.101 (1), p.112-119
issn 0090-0036
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source Open Access: PubMed Central; ABI/INFORM Global (ProQuest); Social Science Premium Collection; American Public Health Association; Politics Collection; PAIS Index; SPORTDiscus; BSC - Ebsco (Business Source Ultimate)
subjects Adult
Aged
Aged, 80 and over
Biological and medical sciences
Breast cancer
Cancer therapies
Chemotherapy
Colonic Neoplasms - mortality
Colonic Neoplasms - therapy
Colorectal cancer
Disease
Early Diagnosis
Female
Gastroenterology. Liver. Pancreas. Abdomen
General aspects
Health insurance
Health Services Accessibility
Health Status Disparities
Humans
Likelihood Functions
Low income groups
Lymphatic system
Male
Medical prognosis
Medical sciences
Medical screening
Middle Aged
Miscellaneous
Missing data
Neighborhoods
Ontario - epidemiology
Poverty
Public health
Public health. Hygiene
Public health. Hygiene-occupational medicine
Radiation therapy
Research and Practice
San Francisco - epidemiology
Social Class
Socioeconomic factors
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Studies
Surgery
Survival Rate
Tumors
Waiting Lists
title Effects of Socioeconomic Status on Colon Cancer Treatment Accessibility and Survival in Toronto, Ontario, and San Francisco, California, 1996-2006
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