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Poorer Patients More Likely to Die After Cancer Diagnosis (dateline July 27, 2008)

Patients with lower socioeconomic statuses are more likely to die after being diagnosed with cancer than wealthier patients, according to new research. In addition, the research found that poor patients are more likely to be diagnosed with more advanced forms of cancer and receive less aggressive treatment. While racial and ethnic disparities have been linked to poorer cancer outcomes in past research, this study highlights socioeconomic status as another factor that needs to be addressed, according to the researchers.

To conduct their study, Tim Byers, M.D. of the University of Colorado Denver and his colleagues examined medical records of over 13,000 cancer patients from seven U.S. states (4,844 women with breast cancer, 4,332 men with prostate cancer, and 4,422 men and women with colorectal cancer). They reviewed information such as cancer stage, treatment received, and 5-year survival rates for the patients. The study was part of the researchers' Breast, Colon, and Prostate Cancer Data Quality and Patterns of Care Study, which uses cancer registries from seven states.

The results of the study showed that patients with lower socioeconomic statuses were more likely to be diagnosed with later stages of cancer, receive less aggressive treatments for their cancer, and die within five years of their diagnosis, compared to patients with higher socioeconomic statuses. The study results will be published in the August 1, 2008 issue of Cancer.

"These findings support the need to focus on socioeconomic status as an important underlying factor in cancer disparities by race and ethnicity," the authors concluded based on the study results. "We need better information on how access to health care contributes to differences in cancer outcomes by socioeconomic status in order to address the root causes of racial and ethnic cancer disparities in the United States."

Specific findings from the study included:

  • Breast cancer patients of low socioeconomic statuses were less likely to receive radiation treatment after a lumpectomy or to receive anti-estrogen therapy such as the drug tamoxifen when diagnosed with cancers that depend on estrogen (called estrogen-receptor positive cancers).
  • Prostate cancer patients who lived in areas with low socioeconomic status were less likely to have been treated with a prostatectomy or radiation compared to patients from areas of high socioeconomic status.
  • Colorectal cancer patients of low socioeconomic statuses were less likely to receive chemotherapy than patients of higher socioeconomic statuses.

Researchers attributed the higher likelihood of death among poorer patients to the more advanced stage of their cancer at diagnosis and the less aggressive treatment they typically received. Lower socioeconomic status appeared to be linked to more deaths within five years of diagnosis regardless of race or ethnicity. However, poor patients over 65 years of age did not have the same likelihoods of death, perhaps because these patients have better access to health care through Medicare, which offers cancer screening and treatment to patients regardless of socioeconomic status.

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