Disparities in survival of stomach cancer among different socioeconomic groups in North-East Netherlands

Ester J.M. Siemerink, Geke A. Hospers, Nanno Mulder, Sabine Siesling, Maaike A. van der Aa

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background: Survival differences in stomach cancer are depended on patient, tumour and treatment factors. Some populations are more prone to develop stomach cancer, such as people with low socioeconomic status (SES). The aim of this population based study was to assess whether differences in socioeconomic status (SES) alone, after adjusting for confounding factors, also influence survival. Methods: From 1989 to 2007 all patients with stomach cancer were selected from the cancer registry of the Comprehensive Cancer Centre North-East. Postal code at diagnosis was used to determine SES, dividing patients in three groups; low, intermediate and high SES. Associations between age, localization, grade, stage, and treatment were determined using Chi-square analysis. Relative survival analysis was used to estimate relative excess risk (RER) of dying according to SES. Results: In low SES neighbourhoods diagnosis was established at older age. More distal tumours were detected in patients with low SES, whereas pathology showed more poorly differentiated tumours in patients with high SES. Overall, more resections were performed in, and more chemotherapy was administrated to patients in high SES neighbourhoods. After adjusting for confounding factors, the risk of dying was lower for patients with high SES (RER 0.89, 95% Confidence Interval 0.81–0.98) compared to patients with low SES. Conclusion: SES proved to be an independent prognostic factor for survival in patients with stomach cancer.
Original languageEnglish
Pages (from-to)413-416
JournalCancer epidemiology
Volume35
Issue number5
DOIs
Publication statusPublished - 2011

Fingerprint

Social Class
Netherlands
Stomach Neoplasms
Survival
Neoplasms
Survival Analysis
Population
Registries
Confidence Intervals
Pathology
Drug Therapy

Keywords

  • Outcome
  • Survival
  • Socioeconomic factors
  • IR-77768
  • North East Netherlands
  • Stomach cancer
  • METIS-275139
  • Socioeconomic status

Cite this

Siemerink, Ester J.M. ; Hospers, Geke A. ; Mulder, Nanno ; Siesling, Sabine ; van der Aa, Maaike A. / Disparities in survival of stomach cancer among different socioeconomic groups in North-East Netherlands. In: Cancer epidemiology. 2011 ; Vol. 35, No. 5. pp. 413-416.
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Disparities in survival of stomach cancer among different socioeconomic groups in North-East Netherlands. / Siemerink, Ester J.M.; Hospers, Geke A.; Mulder, Nanno; Siesling, Sabine; van der Aa, Maaike A.

In: Cancer epidemiology, Vol. 35, No. 5, 2011, p. 413-416.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Disparities in survival of stomach cancer among different socioeconomic groups in North-East Netherlands

AU - Siemerink, Ester J.M.

AU - Hospers, Geke A.

AU - Mulder, Nanno

AU - Siesling, Sabine

AU - van der Aa, Maaike A.

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N2 - Background: Survival differences in stomach cancer are depended on patient, tumour and treatment factors. Some populations are more prone to develop stomach cancer, such as people with low socioeconomic status (SES). The aim of this population based study was to assess whether differences in socioeconomic status (SES) alone, after adjusting for confounding factors, also influence survival. Methods: From 1989 to 2007 all patients with stomach cancer were selected from the cancer registry of the Comprehensive Cancer Centre North-East. Postal code at diagnosis was used to determine SES, dividing patients in three groups; low, intermediate and high SES. Associations between age, localization, grade, stage, and treatment were determined using Chi-square analysis. Relative survival analysis was used to estimate relative excess risk (RER) of dying according to SES. Results: In low SES neighbourhoods diagnosis was established at older age. More distal tumours were detected in patients with low SES, whereas pathology showed more poorly differentiated tumours in patients with high SES. Overall, more resections were performed in, and more chemotherapy was administrated to patients in high SES neighbourhoods. After adjusting for confounding factors, the risk of dying was lower for patients with high SES (RER 0.89, 95% Confidence Interval 0.81–0.98) compared to patients with low SES. Conclusion: SES proved to be an independent prognostic factor for survival in patients with stomach cancer.

AB - Background: Survival differences in stomach cancer are depended on patient, tumour and treatment factors. Some populations are more prone to develop stomach cancer, such as people with low socioeconomic status (SES). The aim of this population based study was to assess whether differences in socioeconomic status (SES) alone, after adjusting for confounding factors, also influence survival. Methods: From 1989 to 2007 all patients with stomach cancer were selected from the cancer registry of the Comprehensive Cancer Centre North-East. Postal code at diagnosis was used to determine SES, dividing patients in three groups; low, intermediate and high SES. Associations between age, localization, grade, stage, and treatment were determined using Chi-square analysis. Relative survival analysis was used to estimate relative excess risk (RER) of dying according to SES. Results: In low SES neighbourhoods diagnosis was established at older age. More distal tumours were detected in patients with low SES, whereas pathology showed more poorly differentiated tumours in patients with high SES. Overall, more resections were performed in, and more chemotherapy was administrated to patients in high SES neighbourhoods. After adjusting for confounding factors, the risk of dying was lower for patients with high SES (RER 0.89, 95% Confidence Interval 0.81–0.98) compared to patients with low SES. Conclusion: SES proved to be an independent prognostic factor for survival in patients with stomach cancer.

KW - Outcome

KW - Survival

KW - Socioeconomic factors

KW - IR-77768

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KW - Stomach cancer

KW - METIS-275139

KW - Socioeconomic status

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