Sameh Hany Emile, Nir Horesh, Zoe Garoufalia, Rachel Gefen, Justin Dourado, Anjelli Wignakumar, Steven D Wexner
{"title":"家庭收入与直肠癌直肠切除术后的总体生存率和癌症特异性生存率独立相关：一项监测、流行病学和最终结果分析。","authors":"Sameh Hany Emile, Nir Horesh, Zoe Garoufalia, Rachel Gefen, Justin Dourado, Anjelli Wignakumar, Steven D Wexner","doi":"10.1016/j.amjsurg.2025.116191","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>We assessed association among household income, overall survival (OS), and cancer-specific survival (CSS) after proctectomy for rectal cancer.</p><p><strong>Methods: </strong>Population-based cohort study included stage I-III rectal adenocarcinoma patients who underwent proctectomy (2010-2020), subdivided by household income at diagnosis [low (<$50,000), average ($50,000-74,999), above-average (≥$75,000)] and compared.</p><p><strong>Results: </strong>Of 39,185 patients (59 % male; mean age 60.4), 12.5 % had low, 48.1 % had average, and 39.4 % had above-average income. Low-income patients were more often Black, rural dwellers, and undergone total proctectomy (OR: 1.49, p < 0.001). Income <$50,000 patients had shorter restricted mean OS (p < 0.001) and CSS (p < 0.001) than the other groups. 5-year OS (70.5 % vs. 73.6 % vs. 82.3 %, p < 0.001) and CSS (78.3 % vs. 80.6 % vs. 87.2 %, p < 0.001) were significantly lower in the low-income group than the average and above-average income groups. Adjusted for other factors, low-income was an independent predictor of OS (HR: 1.31, 95%CI: 1.22-1.41) and CSS (HR: 1.31, 95%CI: 1.21-1.43), compared to above-average.</p><p><strong>Conclusions: </strong>Black patients and rural dwellers more often had <$50,000 income. Low-income increased odds of undergoing non-restorative surgery for rectal cancer and reduced OS and CSS.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"242 ","pages":"116191"},"PeriodicalIF":2.7000,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Household income is independently associated with overall and cancer-specific survival after proctectomy for rectal cancer: A surveillance, epidemiology, and end results-based analysis.\",\"authors\":\"Sameh Hany Emile, Nir Horesh, Zoe Garoufalia, Rachel Gefen, Justin Dourado, Anjelli Wignakumar, Steven D Wexner\",\"doi\":\"10.1016/j.amjsurg.2025.116191\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>We assessed association among household income, overall survival (OS), and cancer-specific survival (CSS) after proctectomy for rectal cancer.</p><p><strong>Methods: </strong>Population-based cohort study included stage I-III rectal adenocarcinoma patients who underwent proctectomy (2010-2020), subdivided by household income at diagnosis [low (<$50,000), average ($50,000-74,999), above-average (≥$75,000)] and compared.</p><p><strong>Results: </strong>Of 39,185 patients (59 % male; mean age 60.4), 12.5 % had low, 48.1 % had average, and 39.4 % had above-average income. Low-income patients were more often Black, rural dwellers, and undergone total proctectomy (OR: 1.49, p < 0.001). Income <$50,000 patients had shorter restricted mean OS (p < 0.001) and CSS (p < 0.001) than the other groups. 5-year OS (70.5 % vs. 73.6 % vs. 82.3 %, p < 0.001) and CSS (78.3 % vs. 80.6 % vs. 87.2 %, p < 0.001) were significantly lower in the low-income group than the average and above-average income groups. Adjusted for other factors, low-income was an independent predictor of OS (HR: 1.31, 95%CI: 1.22-1.41) and CSS (HR: 1.31, 95%CI: 1.21-1.43), compared to above-average.</p><p><strong>Conclusions: </strong>Black patients and rural dwellers more often had <$50,000 income. Low-income increased odds of undergoing non-restorative surgery for rectal cancer and reduced OS and CSS.</p>\",\"PeriodicalId\":7771,\"journal\":{\"name\":\"American journal of surgery\",\"volume\":\"242 \",\"pages\":\"116191\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-01-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.amjsurg.2025.116191\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.amjsurg.2025.116191","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
Household income is independently associated with overall and cancer-specific survival after proctectomy for rectal cancer: A surveillance, epidemiology, and end results-based analysis.
Background: We assessed association among household income, overall survival (OS), and cancer-specific survival (CSS) after proctectomy for rectal cancer.
Methods: Population-based cohort study included stage I-III rectal adenocarcinoma patients who underwent proctectomy (2010-2020), subdivided by household income at diagnosis [low (<$50,000), average ($50,000-74,999), above-average (≥$75,000)] and compared.
Results: Of 39,185 patients (59 % male; mean age 60.4), 12.5 % had low, 48.1 % had average, and 39.4 % had above-average income. Low-income patients were more often Black, rural dwellers, and undergone total proctectomy (OR: 1.49, p < 0.001). Income <$50,000 patients had shorter restricted mean OS (p < 0.001) and CSS (p < 0.001) than the other groups. 5-year OS (70.5 % vs. 73.6 % vs. 82.3 %, p < 0.001) and CSS (78.3 % vs. 80.6 % vs. 87.2 %, p < 0.001) were significantly lower in the low-income group than the average and above-average income groups. Adjusted for other factors, low-income was an independent predictor of OS (HR: 1.31, 95%CI: 1.22-1.41) and CSS (HR: 1.31, 95%CI: 1.21-1.43), compared to above-average.
Conclusions: Black patients and rural dwellers more often had <$50,000 income. Low-income increased odds of undergoing non-restorative surgery for rectal cancer and reduced OS and CSS.
期刊介绍：
The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.
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