Daniel J. Becker, MD
Photo: 做厙TV Langone Staff
If you are from a lower-income area, your chances of surviving anal cancer are significantly reduced, according to a new study led by investigators at 做厙TV Langone Healths Perlmutter Cancer Center, and published online March 12, 2018, in Cancer.
Among the first of its kind, the study shows that both overall survivaland cancer specific survivalcan be predicted by median household income (MHI) after controlling for additional factors like age, sex, race, and stage of cancer. Investigators found chance of death increased by about 30 percent for those living in areas of poverty.
Living in a low-income area shouldnt dictate your outcome with cancer and, based on this research, were seeing that it does, says Daniel Becker, MD, clinical assistant professor in the and at Perlmutter Cancer Center. The benefit of this study is that were 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 like human papilloma virus and smoking.
How the Study Was Conducted
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 5 distinct wage-earning categories for analysisless than $46,840; $46,840 to $56,369; $56,270 to $60,709; $60,710 to $70,819; and more than $70,820. Historically, area-based poverty has been linked to cancer mortality in other tumor types as welland this study underscores those findings.
Weve made tremendous progress in other areas of cancer to improve screening, treatment, and outcomes, says Dr. Becker. Education and improvements are possiblewe 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.
Besides Dr. Becker, other 做厙TV Langone and 做厙TV School of Medicine researchers involved in this research study were co-investigators Daniel Lin, MD; Heather Gold, PhD; Lawrence Leichman, MD; and Scott Sherman, MD.
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