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Effects of socioeconomic status on colon cancer treatment accessibility and survival in Toronto, Ontario, and San Francisco, California, 1996-2006

Author

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  • Gorey, K.M.
  • Luginaah, I.N.
  • Bartfay, E.
  • Fung, K.Y.
  • Holowaty, E.J.
  • Wright, F.C.
  • Hamm, C.
  • Kanjeekal, S.M.

Abstract

Objectives: We examined the differential effects of socioeconomic status on colon cancer care and survival in Toronto, Ontario, Canada, and San Francisco, California. Methods: 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. Results: 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. Conclusions: 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.

Suggested Citation

  • Gorey, K.M. & Luginaah, I.N. & Bartfay, E. & Fung, K.Y. & Holowaty, E.J. & Wright, F.C. & Hamm, C. & Kanjeekal, S.M., 2011. "Effects of socioeconomic status on colon cancer treatment accessibility and survival in Toronto, Ontario, and San Francisco, California, 1996-2006," American Journal of Public Health, American Public Health Association, vol. 101(1), pages 112-119.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2009.173112_4
    DOI: 10.2105/AJPH.2009.173112
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    Cited by:

    1. Hla-Hla Thein & Kika Anyiwe & Nathaniel Jembere & Brian Yu & Prithwish De & Craig C Earle, 2017. "Effects of socioeconomic status on esophageal adenocarcinoma stage at diagnosis, receipt of treatment, and survival: A population-based cohort study," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-20, October.
    2. Sean A. P. Clouston & Marcie S. Rubin & Jo C. Phelan & Bruce G. Link, 2016. "A Social History of Disease: Contextualizing the Rise and Fall of Social Inequalities in Cause-Specific Mortality," Demography, Springer;Population Association of America (PAA), vol. 53(5), pages 1631-1656, October.
    3. Nathaniel Jembere & Michael A Campitelli & Morris Sherman & Jordan J Feld & Wendy Lou & Stuart Peacock & Eric Yoshida & Murray D Krahn & Craig Earle & Hla-Hla Thein, 2012. "Influence of Socioeconomic Status on Survival of Hepatocellular Carcinoma in the Ontario Population; A Population-Based Study, 1990–2009," PLOS ONE, Public Library of Science, vol. 7(7), pages 1-10, July.

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