Lower Socioeconomic Status Decreases Chances of Early Detection and Survival of Colorectal Cancer
November 18, 2008
WASHINGTON, D.C. - An abstract presented at the American Association for Cancer Research's Seventh Annual International Conference on Frontiers in Cancer Prevention Research shows that lower socioeconomic status reduced the chance of early-stage diagnosis and survival of colorectal cancer in Colorado.
"Diagnosis of colorectal cancer at an early stage can lead to better survival. Good screening tests for early-stage diagnosis of colorectal cancer are available," Alma Palisoc, M.D., a preventive medicine resident physician at the University of Colorado Denver and lead author of the study, said. "However, those in the lower socioeconomic groups and those having no health insurance or only Medicaid coverage are more likely to be diagnosed with colorectal cancer at a later stage of disease when survival is worse."
In the study, Palisoc, and her co-authors from the Colorado School of Public Health and the Colorado Department of Public Health and Environment, used data from 21,212 colorectal cancers reported to the Colorado Central Cancer Registry over a 12-year period. Using information from the 2000 U.S. census on block group socioeconomic characteristics, they then examined differences in early-stage diagnosis and five-year, cause-specific survival by socioeconomic status.
They found early-stage diagnosis was less common for all three socioeconomic groups among those with no health insurance or only Medicaid coverage. They also observed that early-stage diagnosis was less common among those younger than 65 among lower socioeconomic groups. "In contrast, for those 65 and older, Medicare covers colorectal cancer screening tests and so earlier-stage diagnosis was observed to be similar among the three groups." More important, for those under the age of 65, there was a 19 percent decrease in five-year survival between the higher and lower groups.
"We concluded that both lack of health insurance and being in a lower socioeconomic strata are important risk factors for later stage colorectal cancers and for poorer survival from colorectal cancer," Palisoc said.
Colorectal cancer incidence rates have declined considerably over the last two decades, due to increased screening, which allows physicians to detect and remove colorectal polyps before forming cancer. "Later detection and, therefore, lower survival of colorectal cancer among those in the low socioeconomic strata were most likely due to barriers in accessing screening tests," Palisoc said.
"These findings can hopefully raise more awareness to the importance of removing barriers to lifesaving health services such as screening tests and treatment for colorectal cancer," Palisoc said. "We need to identify ways to provide such services in Colorado and across the nation, even for people without health insurance."
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The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, AACR is the world's oldest and largest professional organization dedicated to advancing cancer research. The membership includes more than 28,000 basic, translational and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and 80 other countries. The AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants. The AACR Annual Meeting attracts more than 17,000 participants who share the latest discoveries and developments in the field. Special conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment and patient care. The AACR publishes five major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; and Cancer Epidemiology, Biomarkers & Prevention. The AACR's most recent publication and its sixth major journal, Cancer Prevention Research, is dedicated exclusively to cancer prevention, from preclinical research to clinical trials. The AACR also publishes CR, a magazine for cancer survivors and their families, patient advocates, physicians and scientists. CR provides a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship and advocacy.
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