Association Between Socioeconomic Position and Diagnosis, Treatment and Survival of Patients With Stage I-III Rectal Cancer in the Netherlands.

Individual and composite socioeconomic inequalities in diagnosis, treatment, and survival of kidney cancer: a population-based analysis of the SEER database

Survival outcome of Gallbladder cancer in the US: An updated surveillance, epidemiology, and end results-based analysis of age and gender disparities

Introduction: Gallbladder cancer (GBC) is a rare but highly lethal malignancy with significant variability in mortality based on demographic and clinical factors. This study aims to analyze the impact of gender, age, tumor stage, and treatment modalities on mortality in GBC patients, providing a comprehensive overview of the factors influencing survival outcomes. Methods: We conducted a retrospective analysis of 1,527 patients diagnosed with GBC between 2005 and 2021. Data were collected on demographic variables, tumor stage, treatment modalities (chemotherapy, surgery, radiation), and survival outcomes. Multivariate Cox proportional hazards models were used to estimate hazard ratios (HRs) for overall and cancer-related mortality, adjusting for potential confounders. Results: The study cohort comprised 1,527 patients, predominantly female (68.11%), with most patients diagnosed between ages 60 and 79 years (56.65%). The majority were married (59.66%), and most tumors were at a regional stage (65.49%) at diagnosis. Non-Hispanic whites were the largest racial group (50.03%), followed by Hispanics (23.51%). A significant proportion of patients resided in metropolitan areas (60.64%) and had annual incomes between $60,000 and $79,999 (41.00%). High rates of radiation (85.46%) and chemotherapy (76.03%) were observed, with 81.34% undergoing surgery. Multivariate analysis revealed that male gender was associated with a higher overall mortality risk (HR=1.19, 95% CI 1.05-1.36, p Conclusion: Our study underscores the critical role of demographic and clinical factors in influencing GBC outcomes. Male gender, older age, and distant tumor stage are significant predictors of higher mortality, while chemotherapy and surgery substantially improve survival. The findings highlight the necessity for targeted interventions and personalized treatment approaches to enhance survival rates in GBC patients, taking into account these key prognostic factors. Further research is warranted to explore the nuanced effects of racial and ethnic disparities in GBC outcomes.

Treatment strategies and oncological outcomes across national guideline periods in rectal cancer: a population-based cohort study

The shift towards more selective use of preoperative radiotherapy in rectal cancer raises concern that locoregional control may be compromised. The aim was to evaluate whether changes in staging, risk stratification, and treatment across three national guideline periods were associated with differences in oncological outcomes in patients with clinical stage I–III rectal cancer treated with curative intent. 2035 patients from Dalarna, Gävleborg, and Uppsala County with clinical stage I-III rectal cancer were included. Data were obtained from the Swedish Colorectal Cancer Registry and supplemented by review of electronic patient records. Logistic regression with guideline period modelled as an ordinal variable was used to assess differences in treatment over time. Associations between guideline period and oncological outcomes were analysed using unadjusted and adjusted Cox and Fine-Gray models. The proportion of patients staged as cN0 increased over time (OR per period 1.40, 95% c.i. 1.25–1.56), whereas the proportion of patients with cN2 decreased (OR 0.67, 95% c.i. 0.59–0.76). Direct surgery increased (26, 33, and 43%), while overall preoperative treatment (44, 40, and 31%) and short-course radiotherapy (35, 27, 12%) decreased over time. Locoregional recurrence was 3.1% at 5 years and did not differ between guideline periods. No differences were observed in distant metastasis, overall survival, or relative survival after adjustment, although unadjusted analyses suggested lower distant metastasis rates in the most recent period. Reduced use of preoperative radiotherapy was not associated with impaired oncological outcomes. The findings support a more selective radiotherapy use while maintaining oncological safety and reducing treatment-related morbidity.

Factors affecting lung cancer stage at diagnosis and receipt of surgery in Ontario: A population-based analysis

Interventions addressing primary care attachment and upstream social determinants may improve early detection and access to curative therapy in lung cancer stage at diagnosis and surgical treatment persist in Ontario.

Socioeconomic disparities in survival of patients with superficial colorectal cancer

Limited data are available regarding the impact of socioeconomic disparities on the survival of patients with superficial colorectal cancer (SCRC). We used population-based data from the U.S. Surveillance, Epidemiology, and End Results (SEER) program registry to conduct a retrospective cohort study to examine the impact of gender, race, geographic location, and socioeconomic factors on survival outcomes in SCRC patients. Additionally, we explored how socioeconomic factors influenced survival in SCRC patients when stratified by age at diagnosis. To assess the influence of socioeconomic factors on overall survival (OS) and cancer-specific survival (CSS), we employed the Cox proportional hazards model, adjusting for relevant clinical characteristics. 50,671 SCRC patients were included in the final analysis. Compared to patients aged 20–39, older age groups showed progressively higher hazards of CSS, with adjusted hazard ratios (AHR) of 1.21 (95%CI 0.85–1.72) for the 40–49 age group, 1.45 (95%CI 1.05-2.00) for the 50–59 age group, 1.97 (95%CI 1.43–2.70) for the 60–69 age group, and 4.25 (95%CI 3.11–5.82) for those aged 70 or older. Statistically significant increases in CSS hazard were observed in the 50–59, 60–69 and 70 years or older age groups. The AHR for OS among patients aged 40–49, 50–59, 60–69, and 70 or older was 1.54 (95%CI 1.18–2.01), 2.24 (95%CI 1.75–2.86), 4.07 (95%CI 3.20–5.18), and 10.98 (95%CI 8.65–13.94), respectively. Female patients had higher 5-year CSS (by 0.80% points) and OS (by 2.50% points) rates compared to male patients. Black patients showed comparable CSS to White patients. However, their OS was significantly lower (AHR = 1.08, 95% CI 1.02–1.14), corresponding to a 1.70-percentage-point reduction in the 5-year OS rate. Furthermore, among patients aged 50–59, the hazard of death was elevated for those who were unmarried (AHR = 1.90, 95% CI 1.68–2.15) or had low income (AHR = 2.27, 95% CI: 1.62–3.18) alone, but it was markedly higher for those possessing both risk factors (AHR = 3.63, 95% CI 2.17–6.10). Rural residents also demonstrated a survival advantage, particularly in the 40–49 age group. This study found significant socioeconomic disparities in SCRC survival, with older age, male gender, Black race, unmarried status, and lower income associated with poorer outcomes. Moreover, we identified a critical intersectional pattern in which marital status and income were jointly correlated with inferior survival outcomes. Potential strategies including expanded screening coverage, optimized medical care accessibility and culturally adapted health policies are proposed as future research directions, which may help alleviate clinical disparities and facilitate health equity in SCRC management.

Cancer Patients Mortality From Other Causes: A European Population-Based Study.

INTRODUCTION Cancer patients may face elevated mortality not only from their malignancy but also from other factors including multi-morbidity and the impact of treatment-related complications. This study analyses mortality from all causes other than the index cancer among cancer patients compared to the general population. METHODS We analysed EUROCARE-6 data on 1,894,057 cancers diagnosed in 13 European countries and collected by 17 cancer registries with complete official cause-of-death information. Included were first-primary head and neck (H&N), stomach, colorectal, lung, breast, cervical, endometrial, ovarian, prostatic, kidney, and bladder cancers diagnosed between 1998 and 2013 in patients aged 15-79, with follow-up until 31st December 2014. We estimated the relative risk (RR) of death from all other causes for patients relative to population mortality rates. Cause-specific survival (CSS) was compared to relative survival (RS) at 5 and 10 years. RESULTS RR were > 2 for H&N and female lung cancers, between 1 and 2 for stomach, male lung, cervix, endometrial, ovary, kidney and bladder, and < 1 for prostate and female breast cancers. Relative risk declined with increasing age for almost all cancer types. Ten-year CSS exceeded RS by 7%-11% points (pp) in H&N cancers, with smaller differences in bladder (2-6 pp), stomach, lung, cervix, ovary and kidney (2-3 pp). CSS was lower than RS in breast and prostate cancers. CONCLUSION Differentiation between deaths due to the index cancer and to all other causes is crucial for patient follow-up and to improve quality of life. Cause-of-death data should be a core component of population-based cancer registries to inform interpretation of survivorship data.