Combined effect of individual and neighborhood SES in esophageal

cancer2013/7/16

吳晉嘉

• Topic• Literature Review• Coding sheet of literature• Introduction• Result• Limitation

• Combined effect of individual and neighborhood SES in esophageal cancer

Literature Review

• Combined effect of individual and neighborhood SES in gastric cancer patients Literature.

• Pubmed: “socioeconomic status” AND “esophageal cancer”

Coding SheetNo Journal Year Title Authors Main conclusion

1 NEJM 2003 Esophageal cancer Enzinger Review of esophageal cancer

2 BMC cancer 2012incidence and survival of esophageal and gastric cancer

Coupland incidence and survival.Primary prevention

3Indian journal of cancer

2012

Risk factors and survival analysis of the esophageal cancer in the population of Jammu, India

Sehgal

snuff, salt tea, smoking and sundried food are the most powerful risk factor of esophageal cancer.

improve economic status

4

Asian Pacific journal of cancer prevention

2011Epidemiologic risk factors fir esiohageal cacer development

Mao Rsik factors and EC development

Nitrosamine, tabacco abd alcohol, BE and GERDm nutrition, HPV

5 BJC 2006

Role of SES in decision making on dx and tx of esophageal cancer in Netherlands

Vliet

individual SES related to histology . Higher SES related to resection. Lower SES: stent. High SES: more C/T but not significant

6 BJC 2004 Trends and SES inequality in cancer survival Coleman

Deprived patients not benefitial from earlier diagnosis and treatment

Ref: Dixon, High SES more resources

7 JCGE 2012 SES , staging and treat decisions in EC BUS

SES related to tx choice.Netherlan. Related to patient and physician??

Curative treatment==> similar survival. Neighborhood. High ==> curative resection, or CCRT ==> better survival

8

international journal of epidemiology

2009SES, population based case control study in high risk area,Iran

Islami high SES, low risk.Individual. Multiple SES measures. Occupation, area, education

9

Journal of epidemiol Coomunity health

2001 Neighborhood SES and health outcomes Pickett Neighborhood SES rekated to

health outcom

10Cancer epidemiology

2005SES and esophageal adenocarcinoma in Sweden

Janssonindividual SES related EAC and ESC, high ==> low. Especially without partner.

11

health and quality of life outcomes

2009Quality of life as prognostic factor in cancer survival.

Montazeri Fatigue, physical function

12 PLOS one 2013

Sociodemographic and geographical factor in EC and GC mortality in Sweden

Ljung

neighborhood : density high ==> poorer outcome. Single: poorer. High education: better outcome

13 EJC 2008

Sociol inequality, incidence and survival of EC and GC and PC in Denmark

Baastrup

high SES, low risk. Disadvantaged group ==> lower survival but not significant

14 JCO 1999 Community income and cancer survival Boyd Canada remove SES inequality

more than US

15 BJC 2006Impact if SES ib death rate after surgery for UGI cancer

LeighAfter surgery, social deprivation significant associated mortality

16 CA: cancer J clin 2011 Global cancer statistics Jemal Statistics

17

international journal of epidemiology

2007 SES, risk of GC and EC in European Nagel GC related to SES, others no

specific.

18 Ann Surg Oncol. 2013

Outcome of Patients with Esophageal Cancer: A Nationwide Analysis.

Chen

age, sex, and curative treatment were significant predictors of lifetime survival in patients with esophageal cancer.

• SES related to esophageal cancer incidence.• In developed country EAC and ESCC related to

high SES ( Denmark )• In developing countries ESCC related to low

SES• SES related to treatment choice of esophageal

cancer• Surgery improved outcome• Low Neighborhood SES related higher post-

esophagectomy mortality.

• Plos one 2013 : neighborhood and individual SES, but no combination.

• Limited literature about combined effect of neighborhood and individual SES

Study Design

• Taiwan’s NHIRD for the years 2002 to 2006. • 6557 Esophageal cancer patient• Combined Individual SES and neighborhood

SES survival• Individual: occupation and insurance income• Neighborhood: average household income

台灣不分性別 每 10 萬人口標準化發生率 (2000 年世界標準人口 ) ， 2002-

2006 年

年度

食道

個案數 平均年齡 年齡中位數 標準化率 癌症百分比

2002 1,310 61 61 5.47 2.08%

2003 1,356 61 61 5.42 2.14%

2004 1,534 60 59 5.99 2.16%

2005 1,527 59 58 5.76 2.13%

2006 1,764 59 57 6.44 2.34%

7,491

國健局網站 癌登系統

<65 years old

食道

年度 個案數 平均年齡 年齡中位數 標準化率 癌症百分比

2002 787 52 52 3.65 2.34%

2003 810 52 52 3.61 2.41%

2004 963 52 52 4.17 2.56%

2005 983 51 51 4.07 2.58%

2006 1,175 52 52 4.74 2.95

>65years old

食道

年度 個案數 平均年齡 年齡中位數 標準化率 癌症百分比

2002 523 74 73 25.78 1.77%

2003 546 74 74 25.69 1.84%

2004 571 74 73 26.4 1.72%

2005 544 74 73 24.61 1.62%

2006 589 75 74 25.47 1.66%

Limitation

• No staging ( If limited to curative resection, may overcome this bias ) previous review showed that the most important factor is “curative resection”

• No histopathological report ( more than 90% in Asian is SCC )