In the USA, a correlation has been demonstrated between socio-economic status of patients, tumor histology, stage of the disease and treatment modality.
It is unknown whether such correlations are also involved in patients with esophageal cancer.
Dr Siersema and colleagues from the Netherlands evaluated a prospective database of 888 esophageal cancer patients between 1993 and 2003.
The research team assessed the treatment of esophageal cancer.
Socio-economic status of patients was defined as the average net yearly income.
|Low socio-economic status increases squamous cell cancer risk|
|British Journal of Cancer|
Linear-by-linear association testing revealed that esophageal adenocarcinoma was more frequently observed in patients with higher socio-economic status.
The researchers also noted squamous cell carcinoma more frequently in patients with lower socio-economic status.
The researchers identified no correlation between socio-economic status, and staging procedures and preoperative tumor node metastases stage.
The team found that the adjusted odds ratio for stent placement was 0.8.
This indicates that with an increase in socio-economic status by 1200, the likelihood that a stent was placed declined by 18%.
Patients with a higher socio-economic status more frequently underwent resection or were treated with chemotherapy.
Dr Siersema's team concludes, “Socio-economic factors are involved in esophageal cancer in The Netherlands.”
“Patients with a higher socio-economic status are more likely to have an adenocarcinoma and patients with a lower socio-economic status a squamous cell carcinoma.”
“Moreover, the correlations between socio-economic status, and different treatment modalities suggest that both patient and doctor determinants contribute to the decision on the most optimal treatment modality in patients with esophageal cancer.”