Neighborhood level socioeconomic disparities are associated with reduced colorectal cancer survival

Abstract

Abstract We evaluated the relationship between residing in persistent poverty (PP) and low socioeconomic census tracts on all-cause and colorectal cancer (CRC)-specific mortality, providing a current assessment of economic disadvantage and health outcomes. Using Surveillance, Epidemiology, and End Results Program Data (2006–2020), CRC cases were identified using ICD-10 codes and stage I-III were included in the analysis. Overlap propensity score weighting with marginal structural models estimated the risk of all-cause and CRC-specific mortality. Individuals living in PP had higher risk of all-cause mortality at 15-year follow-up, with an adjusted risk difference (ARD) and adjusted risk ratio (aRR) of 7.2 (95% CI 5.9–8.7) and 1.1 (95% CI 1.1–1.1), respectively, with similar results for CRC-specific mortality. Individuals living in low socioeconomic census tracts had higher risk of all-cause (ARD: 5.3, 95% CI 4.0–6.6; aRR: 1.1, 95% CI 1.6–1.1) and CRC-specific mortality (ARD: 2.7, 95% CI 1.7–3.7; aRR: 1.1, 95% CI 1.1–1.1) at 15-year follow-up. Thus, residing in PP or low socioeconomic census tract may impact health outcomes.