It is postulated that patients with upper gastrointestinal cancers from affluent classes have better survival outcomes than those from deprived backgrounds.
Dr Dutta Roy and colleagues from England analyzed the incidence, mortality, and survival of esophageal, gastric, and pancreatic cancers.
The researchers assessed the West Midlands in England from 1986 to 2000 in terms of socioeconomic deprivation.
A well-validated demographic score, the Townsend Band, was employed as a measure of socioeconomic status.
The researchers collated data from a cancer registry database.
The individuals were allocated to 1 of 5 Townsend bands by using the postcodes at diagnosis.
The team calculated relative survival rates by using stratified actuarial life tables.
| Gastric cancer incidence fell preferentially by 31% in the most-deprived men|
Regression trend analysis was performed at 1 and 5 years, and the p value was derived from a t test statistic.
The researchers found that an increase in esophageal cancer incidence was more marked in the affluent categories, compared with the deprived categories.
Gastric cancer incidence fell preferentially by 31% and 47% in the most-deprived men and women, respectively.
However, the team noted that the incidence for these cancers remained relatively unchanged in the affluent groups.
A marginal overall decrease in pancreatic cancer incidence masked preferential increases in 39% of the most-affluent men and 41% of women.
Small increases in 1- and 5-year survival were noted in affluent subgroups.
The team observed that 1-year survival advantages for esophageal cancer achieved significant levels in the most-affluent categories.
Dr Roy's team concluded, “The esophageal cancer incidence increased preferentially in the affluent groups but with a marginally better survival rate.”
“The gastric cancer incidence decreased noticeably in the most-deprived groups, suggesting that improvements in hygiene with consequent reduction in Helicobacter pylori primarily could be responsible.”
“Pancreatic cancer trends were unrelated to social deprivation and warrant further studies.”