دورية أكاديمية
Defining the Role of Social Vulnerability in Treatment and Survival in Localized Colon Cancer: A Retrospective Cohort Study.
العنوان: | Defining the Role of Social Vulnerability in Treatment and Survival in Localized Colon Cancer: A Retrospective Cohort Study. |
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المؤلفون: | Meier J; University of Texas Southwestern, Department of Surgery, Dallas, TX., Murimwa G; University of Texas Southwestern, Department of Surgery, Dallas, TX., Nehrubabu M; University of Texas at Dallas, Department of Mathematics, Dallas, TX., Yopp A; University of Texas Southwestern, Department of Surgery, Dallas, TX., DiMartino L; University of Texas Southwestern, Peter O'Donnell Jr. School of Public Health, Dallas, TX., Singal AG; University of Texas Southwestern, Division of Digestive & Liver Diseases, Dallas, TX., Zeh HJ 3rd; University of Texas Southwestern, Department of Surgery, Dallas, TX., Polanco P; University of Texas Southwestern, Department of Surgery, Dallas, TX. |
المصدر: | Annals of surgery [Ann Surg] 2024 Mar 28. Date of Electronic Publication: 2024 Mar 28. |
Publication Model: | Ahead of Print |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0372354 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-1140 (Electronic) Linking ISSN: 00034932 NLM ISO Abbreviation: Ann Surg Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: Philadelphia, PA : Lippincott Williams & Wilkins |
مستخلص: | Objective: To determine whether variations in Social Vulnerability Index (SVI) are associated with disparities in colon cancer surgery and mortality. Summary Background Data: Colon cancer mortality is influenced by health care access, which is affected by individual and community-level factors. Prior studies have not used the SVI to compare surgical access and survival in localized colon cancer patients. Further, it is unclear if those above 65 years are more vulnerable to variations in SVI. Methods: We queried the Texas and California Cancer Registries from 2004-2017 to identify patients with localized colonic adenocarcinoma and categorized patients into <65 and ≥65 years. Our outcomes were survival and access to surgical intervention. The independent variable was census tract social vulnerability index, with higher scores indicating more social vulnerability. We used multivariable logistic regression and Cox proportional hazards for analysis. Results: We included 73,923 patients with a mean age of 68.6 years (SD 13.0), mean SVI of 47.2 (SD 27.6), and 51.1% male. After adjustment, increasing SVI was associated with reduced odds of undergoing surgery (OR 0.996; 95% CI 0.995-0.997; P < 0.0001 and increased mortality (HR 1.002; 95% CI 1.001-1.002; P < 0.0001). Patients < 65 years were more sensitive to variation in SVI. Conclusions: Increased social vulnerability was associated with reduced odds of receiving surgery for early-stage colon cancer as well as increased mortality. These findings amplify the need for policy changes at the local, state, and federal level to address community-level vulnerability to improve access to surgical care and reduce mortality. Competing Interests: The authors report no conflicts of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.) |
تواريخ الأحداث: | Date Created: 20240328 Latest Revision: 20240328 |
رمز التحديث: | 20240329 |
DOI: | 10.1097/SLA.0000000000006282 |
PMID: | 38545790 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1528-1140 |
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DOI: | 10.1097/SLA.0000000000006282 |