Household income is independently associated with overall and cancer-specific survival after proctectomy for rectal cancer: A surveillance, epidemiology, and end results-based analysis

IF 2.7 3区医学 Q1 SURGERY American journal of surgery Pub Date : 2025-04-01 Epub Date: 2025-01-09 DOI:10.1016/j.amjsurg.2025.116191

Sameh Hany Emile , Nir Horesh , Zoe Garoufalia , Rachel Gefen , Justin Dourado , Anjelli Wignakumar , Steven D. Wexner

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Abstract

Background

We assessed association among household income, overall survival (OS), and cancer-specific survival (CSS) after proctectomy for rectal cancer.

Methods

Population-based cohort study included stage I-III rectal adenocarcinoma patients who underwent proctectomy (2010–2020), subdivided by household income at diagnosis [low (<$50,000), average ($50,000–74,999), above-average (≥$75,000)] and compared.

Results

Of 39,185 patients (59 % male; mean age 60.4), 12.5 % had low, 48.1 % had average, and 39.4 % had above-average income. Low-income patients were more often Black, rural dwellers, and undergone total proctectomy (OR: 1.49, p < 0.001). Income <$50,000 patients had shorter restricted mean OS (p < 0.001) and CSS (p < 0.001) than the other groups. 5-year OS (70.5 % vs. 73.6 % vs. 82.3 %, p < 0.001) and CSS (78.3 % vs. 80.6 % vs. 87.2 %, p < 0.001) were significantly lower in the low-income group than the average and above-average income groups. Adjusted for other factors, low-income was an independent predictor of OS (HR: 1.31, 95%CI: 1.22–1.41) and CSS (HR: 1.31, 95%CI: 1.21–1.43), compared to above-average.

Conclusions

Black patients and rural dwellers more often had <$50,000 income. Low-income increased odds of undergoing non-restorative surgery for rectal cancer and reduced OS and CSS.

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家庭收入与直肠癌直肠切除术后的总体生存率和癌症特异性生存率独立相关：一项监测、流行病学和最终结果分析。

背景：我们评估了直肠癌直肠切除术后家庭收入、总生存率（OS）和癌症特异性生存率（CSS）之间的关系。方法：以人群为基础的队列研究纳入了接受直肠切除术的I-III期直肠腺癌患者（2010-2020），按诊断时的家庭收入细分(结果：39,185例患者(59%男性；平均年龄60.4岁)，12.5%收入低，48.1%收入一般，39.4%收入高于平均。低收入患者多为黑人和农村居民，并接受了全直肠切除术（OR: 1.49, p）结论：黑人患者和农村居民更常接受全直肠切除术

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.