Poorer Socioeconomic Status May Predict Lower Survival in Patients With Anal Cancer

Key Points

  • Chance of death increased by about 30% for those living in areas of poverty.
  • Other secondary predictors of lower survival from anal cancer include gender (men are more vulnerable), older age, African American race, unmarried status, and when it is diagnosed.

 

Patients with lower income have a significantly reduced chance of surviving anal cancer, according to a new study led by investigators at NYU Langone Health’s Perlmutter Cancer Center published by Lin et al in the journal Cancer. The study shows that both overall and cancer-specific survival can be predicted by median household income (MHI) after controlling for additional factors such as age, sex, race, and stage of cancer. Investigators found the chance of death increased by about 30% for those living in areas of poverty.

“Living in a low-income area shouldn’t dictate your outcome with cancer, and, based on this research, we’re seeing that it does,” said Daniel Becker, MD, Clinical Assistant Professor in the Department of Medicine and Division of Hematology and Medical Oncology at Perlmutter Cancer Center. “The benefit of this study is that we’re identifying higher-risk populations that need additional resources to improve outcomes.”

As a relatively rare but highly treatable disease, squamous cell carcinoma of the anus (SCAA) has been rising in incidence and currently accounts for more than 8,200 cases annually in the United States. This increasing incidence is potentially due to changing trends in sexual behavior and other risk factors such as human papillomavirus and smoking.

Study Findings and Method

MHI had the strongest association with both overall survival and, specifically, survival from anal cancer. Other secondary predictors of lower survival from anal cancer include gender (men are more vulnerable); older age; African American race; unmarried status; and, like in most cancers, when it is diagnosed.

The data on SCAA for this study, collected from the Surveillance, Epidemiology, and End Results Cancer Registry between 2004 and 2013, included a total of 9,550 study participants. MHI, age, sex, race, marital status, stage and grade of cancer, year of diagnosis, and radiation-treatment status were recorded. MHI was broken into five distinct wage-earning categories for analysis—less than $46,840; $46,840–$56,369; $56,370–$60,709; $60,710–$70,819; and more than $70,820. Historically, area-based poverty has been linked to cancer mortality in other tumor types as well—and this study underscores those findings.

“We’ve made tremendous progress in other areas of cancer to improve screening, treatment, and outcomes,” said Dr. Becker. “Education and improvements are possible—we can start by going into these communities to make sure that all patients, regardless of their economic status, have the access to cancer care that they need.”

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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