ArticleCancer medicine2025
Associations of Social Vulnerability and Race-Ethnicity With Gastrointestinal Cancers in the United States.
Article in Cancer medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Genetic Ancestry and Colorectal Cancer in the All of Us Dataset.JAMA network open · 2026Article
- Assessments of social vulnerability on central nervous system cancer disparities in the United States.Communications medicine · 2026Article
- Understanding Cancer Health Disparities.Cancers · 2026Review
- Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNational social determinant of health (SDoH) studies on gastrointestinal cancers (GIC) have observed single GIC-types for surgery but not across all GIC-types, non-surgical treatments outcomes, or mortality. The Social Vulnerability Index (SVI), a validated large-data SDoH-tool, quantifiably characterizes the interrelatedness of SDoH-impact through dynamic, region-contextualized measures.
methodsThis retrospective cohort study assessed GIC patients (20+ years) between 2013 and 2017 from the Surveillance, Epidemiology, and End Results (SEER) database for total and subcomponent social vulnerability associations across 15 SDoH-variables encompassing themes of socioeconomic status, minority-language status, household composition, and housing-transportation measured by the Social Vulnerability Index (SVI). These are measured and contextualized from all US counties. Univariate logistic and linear regressions of these vulnerability associations with treatment receipt (chemotherapy, radiation, primary surgery) and survival were performed for the entire cohort and across race/ethnicity strata.
resultsWith increasing overall social vulnerability, 287,248 patients (162,387 [56.5%] male; 185,250 [64.6%] white) demonstrated decreased receipt of chemotherapy (lowest, pancreas-OR, 0.90; 95% CI, 0.88-0.93), radiotherapy (hepatic-OR, 0.87; 95% CI, 0.85-0.89) and surgery (esophagus-OR, 0.90; 95% CI, 0.87-0.92) for 13/14, 10/14, and 8/14 GIC-types, respectively. Survival period decreases upwards of 21.3% (biliary tract: 6.9-5.4 months) were observed across 7/14 GICs. Treatment receipt and survival decreases were exacerbated for non-White patients for 9/14 GICs. Socioeconomic status, minority-language, household composition, and housing-transportation vulnerabilities differentially contributed to these trends. DISCUSSION: Social vulnerability was associated with worse prognostic and treatment disparities, with certain SDoH-types differentially contributing to these detrimental trends per GIC-type while associations were exacerbated among non-White race/ethnic patients. These real-world contexts present actionable targets for further initiatives to combat GIC disparities.
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