87P - Socio-demographic disparities in esophageal cancer: A SEER analysis

Background

Esophageal cancer is a global health problem claiming more than 500,000 lives annually. Our previous research on other cancers has shown that patients living in rural areas have worse outcomes. This study aimed to investigate the geographic and socio-demographic disparities in esophageal cancer patients.

Methods

We conducted a retrospective study on esophageal cancer patients between 1975 and 2016 using the Surveillance, Epidemiology, and End Results (SEER) database. Both univariate and multivariable analyses were performed to evaluate overall survival (OS) and disease-specific survival (DSS). Socio-demographic factors, including the location of residence [metro area (MA) or rural area (RA)], gender, race, insurance status, and marital status, were analyzed.

Results

A total of 50,097 [RA, N =6,199(12%); MA, N =43,222(88%)] patients were included. During the study period, the incidence and mortality rates were consistently higher in RA vs. MA. Patients living in RA more commonly had adenocarcinoma (64.2% vs. 56.9%, p<0.01) compared to MA. Univariate and multivariable analysis showed that RA had worse OS (multivariate HR = 1.08; p <0.01) and DSS (multivariate HR = 1.07; p <0.01) compared to MA. Similarly, males, single and uninsured patients had worse OS and DSS compared to females, married, and insured patients, respectively. When comparing racial backgrounds, non-Hispanic black (HR=1.19; p<0.01) and Hispanic patients (HR=1.05; p=0.028) had worse OS than their Caucasian counterparts.

Conclusions

Our study identified social and demographic disparities in esophageal cancer incidence and outcomes. Potential causes may include access to healthcare, diet, genetics, health behavior, and environmental factors. Future research is needed to understand and attenuate such disparities.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Roswell Park Comprehensive Cancer Center.

Funding

This research was funded by National Cancer Institute: P30CA016056.

Disclosure

S. Mukherjee: Financial Interests, Institutional, Research Grant: Ipsen biopharmaceuticals; Non-Financial Interests, Personal and Institutional, Member of the Board of Directors: Esophageal Cancer Action Network. All other authors have declared no conflicts of interest.