315084
Effects of Socioeconomic Status on LUNG Cancer Survival in Florida: Results from a Population-Based Cancer Registry (1997-2007)
Methods: Data from Florida Cancer Data System were linked to Florida Agency for HealthCare Administration (1996-2007) for patients diagnosed with lung cancer (n=165,465). Overall survival in months was our primary clinical endpoint. We obtained US census tract-level information on percentage of households living below the federal poverty line and grouped these as: lowest (≥20%), middle-low (≥10% and <20%), middle-high (≥5% and <10%) and highest (<5%). Multivariate adjusted Cox regression models were performed controlling for SES, race, ethnicity, smoking status, insurance, marital status, hospital characteristics, treatment, stage, grade, and comorbidities. Adjusted hazard ratios [HR] and 95% confidence intervals (95%CI) were reported.
Results: A majority of the patients were living in highest and middle-high (54.6%) SES neighborhoods. Median survival time (months) increased by SES level: lowest (6.5), middle-low (7.6), middle-high (8.5) and highest (9.6) SES. Post-diagnosis, survival rates increased from lowest (34.8% at 1-year, 8.6% at 5-years) to highest (44% at 1-year, 15% at 5-years) SES. In the fully adjusted model, compared with lowest SES, better survival was found in middle-low (HR=0.96; 95%CI: 0.93-0.98), middle-high (HR=0.92; 95%CI: 0.89-0.94) and highest (HR=0.88;95%CI: 0.84-0.91) SES.
Discussion: Patients living in higher SES neighborhoods had a survival advantage compared with their poorer counterparts. Improved overall neighborhood access to quality care would be beneficial for lung cancer patients to decrease disparities in at-risk population groups in Florida.
Learning Areas:
Advocacy for health and health educationChronic disease management and prevention
Diversity and culture
Epidemiology
Planning of health education strategies, interventions, and programs
Social and behavioral sciences
Learning Objectives:
Explain how socioeconomic status affects survival of lung cancer patients in the state of Florida. Identify the factors that could confound the survival analyses of lung cancer patients. List the median survival times and 1- and 5-year post-diagnosis survival rates for each level of socioeconomic status.
Keyword(s): Cancer, Epidemiology
Qualified on the content I am responsible for because: I am a graduate student at the University of Miami Miller School of Medicine, Department of Public Health Sciences, and I have been working on this project with my professor for few months as cancer prevention and intervention strategy implementation is one of my biggest areas of interest in public heath research.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.