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The Effect of Individual and Neighborhood Socioeconomic Status on Gastric Cancer Survival
PURPOSE: Gastric cancer is a leading cause of death, particularly in the developing world. The literature reports individual socioeconomic status (SES) or neighborhood SES as related to survival, but the effect of both has not been studied. This study investigated the effect of individual and neighb...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3934911/ https://www.ncbi.nlm.nih.gov/pubmed/24586941 http://dx.doi.org/10.1371/journal.pone.0089655 |
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author | Wu, Chin-Chia Hsu, Ta-Wen Chang, Chun-Ming Yu, Chia-Hui Wang, Yuh-Feng Lee, Ching-Chih |
author_facet | Wu, Chin-Chia Hsu, Ta-Wen Chang, Chun-Ming Yu, Chia-Hui Wang, Yuh-Feng Lee, Ching-Chih |
author_sort | Wu, Chin-Chia |
collection | PubMed |
description | PURPOSE: Gastric cancer is a leading cause of death, particularly in the developing world. The literature reports individual socioeconomic status (SES) or neighborhood SES as related to survival, but the effect of both has not been studied. This study investigated the effect of individual and neighborhood SES simultaneously on mortality in gastric cancer patients in Taiwan. MATERIALS AND METHODS: A study was conducted of 3,396 patients diagnosed with gastric cancer between 2002 and 2006. Each patient was followed for five years or until death. Individual SES was defined by income-related insurance premium (low, moderate, and high). Neighborhood SES was based on household income dichotomized into advantaged and disadvantaged areas. Multilevel logistic regression model was used to compare survival rates by SES group after adjusting for possible confounding factors. RESULTS: In patients younger than 65 years, 5-year overall survival rates were lowest for those with low individual SES. After adjusting for patient characteristics (age, gender, Charlson Comorbidity Index Score), gastric cancer patients with high individual SES had 68% risk reduction of mortality (adjusted odds ratio [OR] of mortality, 0.32; 95% confidence interval [CI], 0.17–0.61). Patients aged 65 and above had no statistically significant difference in mortality rates by individual SES group. Different neighborhood SES did not statistically differ in the survival rates. CONCLUSION: Gastric cancer patients aged less than 65 years old with low individual SES have higher risk of mortality, even under an universal healthcare system. Public health strategies, education and welfare policies should seek to correct the inequality in gastric cancer survival, especially in those with lower individual SES. |
format | Online Article Text |
id | pubmed-3934911 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-39349112014-03-04 The Effect of Individual and Neighborhood Socioeconomic Status on Gastric Cancer Survival Wu, Chin-Chia Hsu, Ta-Wen Chang, Chun-Ming Yu, Chia-Hui Wang, Yuh-Feng Lee, Ching-Chih PLoS One Research Article PURPOSE: Gastric cancer is a leading cause of death, particularly in the developing world. The literature reports individual socioeconomic status (SES) or neighborhood SES as related to survival, but the effect of both has not been studied. This study investigated the effect of individual and neighborhood SES simultaneously on mortality in gastric cancer patients in Taiwan. MATERIALS AND METHODS: A study was conducted of 3,396 patients diagnosed with gastric cancer between 2002 and 2006. Each patient was followed for five years or until death. Individual SES was defined by income-related insurance premium (low, moderate, and high). Neighborhood SES was based on household income dichotomized into advantaged and disadvantaged areas. Multilevel logistic regression model was used to compare survival rates by SES group after adjusting for possible confounding factors. RESULTS: In patients younger than 65 years, 5-year overall survival rates were lowest for those with low individual SES. After adjusting for patient characteristics (age, gender, Charlson Comorbidity Index Score), gastric cancer patients with high individual SES had 68% risk reduction of mortality (adjusted odds ratio [OR] of mortality, 0.32; 95% confidence interval [CI], 0.17–0.61). Patients aged 65 and above had no statistically significant difference in mortality rates by individual SES group. Different neighborhood SES did not statistically differ in the survival rates. CONCLUSION: Gastric cancer patients aged less than 65 years old with low individual SES have higher risk of mortality, even under an universal healthcare system. Public health strategies, education and welfare policies should seek to correct the inequality in gastric cancer survival, especially in those with lower individual SES. Public Library of Science 2014-02-25 /pmc/articles/PMC3934911/ /pubmed/24586941 http://dx.doi.org/10.1371/journal.pone.0089655 Text en © 2014 Wu et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Wu, Chin-Chia Hsu, Ta-Wen Chang, Chun-Ming Yu, Chia-Hui Wang, Yuh-Feng Lee, Ching-Chih The Effect of Individual and Neighborhood Socioeconomic Status on Gastric Cancer Survival |
title | The Effect of Individual and Neighborhood Socioeconomic Status on Gastric Cancer Survival |
title_full | The Effect of Individual and Neighborhood Socioeconomic Status on Gastric Cancer Survival |
title_fullStr | The Effect of Individual and Neighborhood Socioeconomic Status on Gastric Cancer Survival |
title_full_unstemmed | The Effect of Individual and Neighborhood Socioeconomic Status on Gastric Cancer Survival |
title_short | The Effect of Individual and Neighborhood Socioeconomic Status on Gastric Cancer Survival |
title_sort | effect of individual and neighborhood socioeconomic status on gastric cancer survival |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3934911/ https://www.ncbi.nlm.nih.gov/pubmed/24586941 http://dx.doi.org/10.1371/journal.pone.0089655 |
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