Does socioeconomic status influence the choice of surgical technique in abdominal rectal cancer surgery?

IF 2.9 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Colorectal Disease Pub Date : 2025-05-19 DOI:10.1111/codi.70111

Kaveh Dehlaghi Jadid, Soran Gadan, Göran Wallin, Caroline Nordenvall, Sol Erika Boman, Ida Hed Myrberg, Peter Matthiessen

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引用次数: 0

Abstract

Aim

This study aimed to estimate the impact of socioeconomic status on the probability of receiving open (OPEN) or minimally invasive surgery (MIS) for curative abdominal rectal cancer resection.

Methods

All patients diagnosed with rectal cancer clinical Stage I–III during the period 2010–2021 who underwent curative abdominal resection surgery, MIS or OPEN, were included. Patients were identified in the Colorectal Cancer Database, a register-linkage based on the Swedish Colorectal Cancer Register and linked to several national Swedish health-related and demographic registers. Socioeconomic factors, sex, patient and tumour characteristics, number of previous surgical procedures and category of hospital were collected. Exposures were level of education (categorized as 6–9, 10–12, >12 years), household income (quartiles 1–4) and country of birth (Sweden, Nordic countries outside Sweden, Europe outside the Nordic countries, outside Europe), and outcome was MIS or OPEN. Multivariable logistic regression models were fitted for each exposure, adjusted for age, sex, cT and cN, level of tumour, and number of previous abdominal surgical procedures.

Results

A total of 13 778 patients were included of whom 43.6% underwent MIS (n = 6007) and 56.4% OPEN (n = 7771). Highest level of education (OR for highest vs. lowest level of education 1.15; 95% CI 1.03–1.29) and highest household income quartile (OR for highest vs. lowest household income quartile 1.27; 95% CI 1.12–1.44) increased the likelihood of receiving MIS.

Conclusion

Despite the tax-financed healthcare system in Sweden, rectal cancer patients with the highest level of education and the highest household income had an increased probability of receiving MIS.

查看原文本刊更多论文

社会经济地位是否影响腹直肠癌手术技术的选择？

目的本研究旨在评估社会经济状况对接受开放式（open）或微创手术（MIS）治疗性腹直肠癌切除术概率的影响。方法选取2010-2021年期间所有经诊断为直肠癌临床I-III期并行根治性腹部切除术（MIS或OPEN）的患者。在结直肠癌数据库中确定了患者，这是一个基于瑞典结直肠癌登记册的登记联系，并与瑞典几个国家健康和人口登记册相关联。收集了社会经济因素、性别、患者和肿瘤特征、既往手术次数和医院类别。暴露是教育水平（分类为6-9岁、10-12岁和12岁）、家庭收入（四分位数为1-4）和出生国家（瑞典、瑞典以外的北欧国家、北欧国家以外的欧洲、欧洲以外），结果是MIS或OPEN。为每次暴露拟合多变量logistic回归模型，并根据年龄、性别、cT和cN、肿瘤水平和既往腹部手术次数进行调整。结果共纳入13778例患者，其中43.6%行MIS (n = 6007)， 56.4%行OPEN （n = 7771）。最高教育水平(最高教育水平与最低教育水平之比为1.15；95% CI 1.03-1.29)和最高家庭收入四分位数(最高与最低家庭收入四分位数OR 1.27；95% CI 1.12-1.44)增加了接受MIS的可能性。结论尽管瑞典实行税收资助的医疗体系，但受教育程度最高和家庭收入最高的直肠癌患者接受MIS的可能性更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Colorectal Disease 医学-胃肠肝病学

CiteScore

6.10

自引率

11.80%

发文量

406

审稿时长

1.5 months

期刊介绍： Diseases of the colon and rectum are common and offer a number of exciting challenges. Clinical, diagnostic and basic science research is expanding rapidly. There is increasing demand from purchasers of health care and patients for clinicians to keep abreast of the latest research and developments, and to translate these into routine practice. Technological advances in diagnosis, surgical technique, new pharmaceuticals, molecular genetics and other basic sciences have transformed many aspects of how these diseases are managed. Such progress will accelerate. Colorectal Disease offers a real benefit to subscribers and authors. It is first and foremost a vehicle for publishing original research relating to the demanding, rapidly expanding field of colorectal diseases. Essential for surgeons, pathologists, oncologists, gastroenterologists and health professionals caring for patients with a disease of the lower GI tract, Colorectal Disease furthers education and inter-professional development by including regular review articles and discussions of current controversies. Note that the journal does not usually accept paediatric surgical papers.