Outcomes of non-metastatic colon cancer patients in relationship to socioeconomic status: an analysis of SEER census tract-level socioeconomic database

Objective To evaluate the outcomes of non-metastatic colon cancer patients in relation to the socioeconomic status (SES) at diagnosis based on the Surveillance, Epidemiology, and End Results (SEER) census tract level-SES database. Methods SEER SES census tract level database represents a specially designed database to integrate different aspects of SES among cancer patients. It reports a composite SES index for each patient. Patients were then stratified into three SES groups. Patients with a non-metastatic colon cancer diagnosis, diagnosed (2004-2015), and who were included in this specialized database were included in the current study. Multivariate Cox regression analysis was used to assess the impact of SES index on colon cancer-specific survival. Results A total of 80,121 patients with non-metastatic colon cancer were included in the current study. Comparing patients in the lower SES group with patients in the higher SES group, patients with lower SES were more likely to have a younger age at presentation (P < 0.001), black race (P < 0.001) and more advanced stage at presentation (P < 0.001). The impact of the SES on colon cancer-specific survival was evaluated through multivariate Cox regression analysis adjusted for age, sex, race, stage, and colon cancer side. Lower SES was associated with worse colon cancer-specific survival (hazard ratio for group 1 versus group 3: 1.257; 1.190-1.328; P < 0.001). Interaction testing between race (black race versus white race) and SES was non-significant (P = 0.932). Conclusions Lower SES is associated with worse colon cancer-specific survival among non-metastatic colon cancer patients.