ArticleJNCI cancer spectrum2023
Socioeconomic status and inequities in treatment initiation and survival among patients with cancer, 2011-2022.
Article in JNCI cancer spectrum, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
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Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it.
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- Social genomics and cancer - untangling nature from nurture in squamous cell carcinoma outcomes.Frontiers in oncology · 2026Review
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- The association of contemporary mortgage lending bias and receipt of guideline-concordant systemic treatment among older women with breast cancer.Breast cancer research and treatment · 2025Article
- Differences in prostate cancer treatment receipt and timeliness of treatment between African American/Black and White Iowans.Cancer causes & control : CCC · 2025Article
- Assessing inequalities in health utility scores among cancer patients undergoing systemic and radiation therapy.Health and quality of life outcomes · 2025Article
- Gastrointestinal Cancer: Outcomes and Therapeutic Management.Journal of clinical medicine · 2025Article
- Aspiration pneumonia in diabetic ketoacidosis: a decade-long analysis of occurrence , associated risk factors and clinical outcomes in 530,700 US hospitalizations.Diabetology & metabolic syndrome · 2025Article
- The global, regional, and national burden of acute lymphoblastic leukemia, 1990 to 2021: a cross-sectional analysis from the 2021 global burden of disease study.Discover oncology · 2025Article
- Association of Medicaid expansion with colon cancer care: treatment patterns and survival in non-metastatic cases from state registry-claims data.Cancer causes & control : CCC · 2025Article
- A Comprehensive Review of Acute Type A Aortic Dissection: Epidemiology, Classification, Management Strategies, Mortality Risk Assessment, and Ethical Considerations for Patients who Refuse Blood Transfusions.Reviews in cardiovascular medicine · 2025Review
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7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundLower neighborhood socioeconomic status (SES) is associated with suboptimal cancer care and reduced survival. Most studies examining cancer inequities across area-level socioeconomic status tend to use less granular or unidimensional measures and pre-date the COVID-19 pandemic. Here, we examined the association of area-level socioeconomic status on real-world treatment initiation and overall survival among adults with 20 common cancers.
methodsThis retrospective cohort study used electronic health record-derived deidentified data (Flatiron Health Research Database, 2011-2022) linked to US Census Bureau data from the American Community Survey (2015-2019). Area-level socioeconomic status quintiles (based on a measure incorporating income, home values, rental costs, poverty, blue-collar employment, unemployment, and education information) were computed from the US population and applied to patients based on their mailing address. Associations were examined using Cox proportional hazards models adjusted for diagnosis year, age, sex, performance status, stage, and cancer type.
resultsThis cohort included 291 419 patients (47.7% female; median age = 68 years). Patients from low-SES areas were younger and more likely to be Black (21.9% vs 3.3%) or Latinx (8.4% vs 3.0%) than those in high-SES areas. Living in low-SES areas (vs high) was associated with lower treatment rates (hazard ratio = 0.94 [95% confidence interval = 0.93 to 0.95]) and reduced survival (median real-world overall survival = 21.4 vs 29.5 months, hazard ratio = 1.20 [95% confidence interval = 1.18 to 1.22]). Treatment and survival inequities were observed in 9 and 19 cancer types, respectively. Area-level socioeconomic inequities in treatment and survival remained statistically significant in the COVID-19 era (after March 2020).
conclusionTo reduce inequities in cancer outcomes, efforts that target marginalized, low-socioeconomic status neighborhoods are necessary.
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