ArticleCancer causes & control : CCC2021
Effects of socioeconomic status on cancer patient survival: counterfactual event-based mediation analysis.
Article in Cancer causes & control : CCC, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Regional and patient characteristic disparities in the outcomes of minimally invasive surgery for colorectal cancer in Japan.Annals of gastroenterological surgery · 2025Article
- Do Patients of Different Levels of Affluence Receive Different Care for Pediatric Osteosarcomas? One Institution's Experience.Clinical orthopaedics and related research · 2025Article
- Factors impacting time to genetic diagnosis for children with epilepsy.Epilepsia open · 2024Article
- The Impact of Neighborhood Deprivation on the Survival Rates of Patients with Cancer in Korea.Healthcare (Basel, Switzerland) · 2023Article
- How to use the Surveillance, Epidemiology, and End Results (SEER) data: research design and methodology.Military Medical Research · 2023Review
- Survival Mixture Density Networks.Proceedings of machine learning research · 2022Article
- Article
- Analyzing Global Cancer Control: Progress of National Cancer Control Programs through Composite Indicators and Regression Modeling.Journal of medical physicsArticle
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Authors and funding
2 authors.
Funding
Abstract
purposeThis study investigated the direct and indirect effects of socioeconomic status (SES) on the survival time of cancer patients by using cancer stage to create a pathway from SES to health outcomes and facilitate a mechanistic inference.
methodsBoth a traditional mediation analysis and a counterfactual event-based mediation analysis were applied to SEER (The Surveillance, Epidemiology, and End Results) data from the National Cancer Institute of the United States. A Cox proportional hazards model for survival analysis was performed in the mediation analysis.
resultsThe counterfactual event-based mediation analysis showed that the effect of SES on survival time was partially mediated by stage at diagnosis in lung (12%), liver (14.33%), and colorectal (9%) cancers. Investigation of the fundamental mechanism involved thus established the direct effect of SES on survival time and the indirect effect of SES on survival time through stage at diagnosis. Moreover, the mediation analysis also revealed that the disparity in timely diagnosis (i.e., stage at diagnosis) caused by SES was slightly significant.
conclusionsSES can either affect cancer survival directly or indirectly through stage at diagnosis. Opportunities to reduce cancer disparity exist in the design of early detection policies or mechanisms for patients with varying resources.
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