ArticleTranslational cancer research2026
Individual and combined effects of marital status, household income, and residence on cancer management and survival in primary bone cancer: a SEER-based retrospective cohort study.
Article in Translational cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Research on socioeconomic status (SES) disparities in primary bone cancer is limited due to its rarity, despite the potential impact of socioeconomic factors on access to care and clinical outcomes. This study aimed to comprehensively evaluate the individual and combined effects of key SES indicators, including marital status, household income, and residence, on diagnosis, treatment, and survival outcomes, and to develop a composite SES risk score in patients with primary bone cancer. Methods: Primary bone cancer patients diagnosed between 2000 and 2022 were identified from the Surveillance, Epidemiology, and End Results (SEER)-17 registry. Three available SES indicators, including marital status, median household income, and residence, were analyzed individually and combined into a composite SES risk score. The diagnostic-to-treatment interval was assessed; multivariable ordinal logistic regression was used to evaluate stage at diagnosis; multivariable binary logistic regression was applied to examine the likelihood of receiving surgery; and multivariable Cox proportional hazards models were used to analyze overall survival (OS) and cancer-specific survival (CSS), adjusting for key demographic and tumor characteristics. Results: A total of 8,301 patients were included. unmarried status, lower household income, and rural residence were associated with longer time from diagnosis to treatment, lower likelihood of receiving surgery, and poorer survival, whereas only unmarried status was associated with a more advanced stage at diagnosis. When combined into a composite SES risk score, a graded association was observed across outcomes. Compared with patients with low SES risk, those with moderate SES risk had longer intervals (37±51 Conclusions: Marital status, household income, and residence were independently associated with survival outcomes in patients with primary bone cancer and influenced different aspects of cancer management. Moreover, socioeconomic disadvantage showed a cumulative effect across the cancer care continuum. These findings highlight the need for targeted clinical and healthcare system interventions to reduce SES-related disparities and improve equitable access to care.
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