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Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
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Income differences in time to colon cancer diagnosis
Laura E Davis1,2, Erin C Strumpf1,3, Sunil V Patel4
1Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada.
Cancer Medicine
|August 3, 2024
Summary
Low-income patients face longer colon cancer diagnosis times. This study found that individuals in lower-income neighborhoods experienced delays in cancer diagnosis, highlighting income-based health inequities.
Area of Science:
- Oncology
- Health Services Research
- Health Equity
Background:
- Cancer care outcomes are worse for low-income populations.
- Little is known about the impact of income on the cancer diagnostic interval.
- Understanding diagnostic disparities is crucial for improving cancer care equity.
Purpose of the Study:
- To describe colon cancer diagnostic pathways by neighborhood income.
- To investigate the association between neighborhood income and the diagnostic interval.
Main Methods:
- Retrospective cohort study of 64,303 colon cancer patients in Ontario (2007-2019).
- Diagnostic interval defined as days from first encounter to diagnosis.
- Quantile regression analyzed income quintile association with diagnostic interval, controlling for covariates.
Main Results:
- Patients in lowest income neighborhoods were more likely diagnosed via symptomatic pathways and emergency departments.
- Low-income neighborhoods associated with longer symptomatic diagnostic intervals (50th and 90th percentiles).
- The 90th percentile diagnostic interval was 15 days longer for patients in the lowest income neighborhoods compared to the highest.
Conclusions:
- Significant income-based inequities exist during colon cancer diagnosis.
- Further research needed to reduce diagnostic interval inequalities.
- Screening and diagnostic programs require evaluation from an equity perspective.
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