Abstract 5792
Background
To evaluate the impact of socioeconomic factors on survival in stage IV colorectal cancer (CRC).
Methods
The United States National Cancer Database was searched for stage IV colorectal adenocarcinomas diagnosed between 2010 and 2015. Overall survival (OS) was assessed via multivariable Cox proportional Hazards models, adjusting socioeconomic factors for potential confounders.
Results
A total of 73,685 patients with median age of 64 years were included. 54.5% of patients were male. After adjustment for potential confounders, improved OS was seen for female patients (vs. male HR = 0.95, p < 0.001), Caucasians (vs. African Americans HR = 0.95, p < 0.001) and those with higher income (63.000 vs. < 38.000 USD HR = 0.92, p < 0.001). Independently, insurance status impacted survival with higher OS seen for patients with private insurance (vs. Medicaid HR = 0.89, p < 0.001; vs. Medicare HR = 0.85, p < 0.001). Further, OS correlated with type and location of the treating center: improved OS was evident for patients treated at academic/research centers (vs. other centers HR = 0.84, p < 0.001). Highest survival rates were observed in the Middle Atlantic and West South Central US state regions compared to other regions (HR = 1.18 to HR = 1.35, p < 0.001). The table summarizes adjusted 2-year and 5-year overall survival rates by US state region.Table: 572P
Adjusted survival rates for stage IV CRC by US state region
| location | Adjusted Two-year OS | Adjusted Five-year OS |
|---|---|---|
| Middle Atlantic | 43% | 13% |
| West South Central | 43% | 15% |
| Mountain | 38% | 8% |
| South Atlantic | 36% | 8% |
| New England | 35% | 5% |
| Pacific | 35% | 8% |
| East North Central | 34% | 6% |
| East South Central | 32% | 7% |
| West North Central | 32% | 5% |
Conclusions
Socioeconomic factors independently impacted survival in stage IV CRC. Improved outcomes were observed for female Caucasians with high socioeconomic status and access to academic treatment centers in certain US state regions.
Clinical trial identification
NA
Legal entity responsible for the study
Hyun S. Kim, MD.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.