Economic status and survivorship in digestive system cancers

Abstract

This study investigates economic differentials in cancer survival in a sample of 1180 white men, focusing in particular on the relationship between income level and survivorship in the various subsites comprising the digestive system cancer category. Using the Cox proportional hazards model to control for confounding variables, the economic status-survivorship relationship is estimated for several subgroupings of primary malignancies. The results show significant variation in this relationship across different cancer sites, with a pronounced effect observed in carcinomas of the small intestine, peritoneum and, especially, colon and rectum. High-income patients with these malignancies had a significantly lower risk of dying from the disease (P < 0.05) than either their middle- or lower-income counterparts, controlling for age, stage, and initial course of treatment. Differences in immunologic status, tumor characteristics, and follow-up treatment may account for these economic effects.