Socioeconomic deprivation adversely affects survival of patients with rectal cancer

Br J Surg. 2009 Jul;96(7):763-8. doi: 10.1002/bjs.6621.

Abstract

Background: The aim was to examine the influence of socioeconomic deprivation on stage at presentation, perioperative mortality, permanent stoma rates and overall survival in patients with rectal cancer.

Methods: Data on patient demographics, mode and stage of presentation, and short- and longer-term outcomes were extracted from a database of patients with rectal cancer. Comparisons were made after stratification into quintiles of socioeconomic deprivation.

Results: In total 486 patients were identified. Fewer patients from the most deprived group than from the least deprived group underwent resectional surgery (79.2 versus 93 per cent; P = 0.005). Permanent stoma rates among patients who had surgery were 40.8 and 30 per cent respectively (P = 0.110). The overall 5-year survival rate was 32.8 per cent for the most deprived compared with 64.0 per cent for the least deprived patients (P < 0.001). Respective rates for those who underwent resectional surgery were 49.9 and 72 per cent (P = 0.030).

Conclusion: In rectal cancer, socioeconomic deprivation appears to be associated with poorer outcomes and survival. This has important implications for healthcare planning.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • England / epidemiology
  • Epidemiologic Methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Poverty*
  • Prognosis
  • Rectal Neoplasms / mortality*
  • Rectal Neoplasms / surgery
  • Socioeconomic Factors
  • Treatment Outcome