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Impact of Socioeconomic Status on Cancer Incidence Risk, Cancer Staging, and Survival of Patients with Colorectal Cancer under Universal Health Insurance Coverage in Taiwan

Author

Listed:
  • Wei-Yin Kuo

    (Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan
    These authors contributed equally to this work.)

  • Han-Sheng Hsu

    (Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan
    These authors contributed equally to this work.)

  • Pei-Tseng Kung

    (Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan
    Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 404332, Taiwan)

  • Wen-Chen Tsai

    (Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan)

Abstract

This study examined the impact of socioeconomic status on colorectal cancer risk, staging, and survival under the National Health Insurance (NHI) system in Taiwan. Monthly salary and education level were used as measures of socioeconomic status to observe the risk of colorectal cancer among individuals aged 40 years or above in 2006–2015 and survival outcomes of patients with colorectal cancer until the end of 2016. Data from 286,792 individuals were used in this study. Individuals with a monthly salary ≤Q1 were at a significantly lower incidence risk of colorectal cancer than those with a monthly salary >Q3 (HR = 0.80, 95% CI = 0.74–0.85), while those with elementary or lower education were at a significantly higher risk than those with junior college, university, or higher education (HR = 1.18, 95% CI = 1.06–1.31). The results show that socioeconomic status had no significant impact on colorectal cancer stage at diagnosis. Although salary was not associated with their risk of mortality, patients with colorectal cancer who had elementary or lower education incurred a significantly higher risk of mortality than those who had junior college, university, or higher education (HR = 1.39, 95% CI = 1.07–1.77). Education level is a significant determinant of the incidence risk and survival in patients with colorectal cancer, but only income significantly impacts incidence risk.

Suggested Citation

  • Wei-Yin Kuo & Han-Sheng Hsu & Pei-Tseng Kung & Wen-Chen Tsai, 2021. "Impact of Socioeconomic Status on Cancer Incidence Risk, Cancer Staging, and Survival of Patients with Colorectal Cancer under Universal Health Insurance Coverage in Taiwan," IJERPH, MDPI, vol. 18(22), pages 1-17, November.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:22:p:12164-:d:683201
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    References listed on IDEAS

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    1. Hastert, Theresa A. & Ruterbusch, Julie J. & Beresford, Shirley A.A. & Sheppard, Lianne & White, Emily, 2016. "Contribution of health behaviors to the association between area-level socioeconomic status and cancer mortality," Social Science & Medicine, Elsevier, vol. 148(C), pages 52-58.
    2. Hines, R. & Markossian, T. & Johnson, A. & Dong, F. & Bayakly, R., 2014. "Geographic residency status and census tract socioeconomic status as determinants of colorectal cancer outcomes," American Journal of Public Health, American Public Health Association, vol. 104(3), pages 63-71.
    3. Chun-Ming Chang & Yu-Chieh Su & Ning-Sheng Lai & Kuang-Yung Huang & Sou-Hsin Chien & Yu-Han Chang & Wei-Cheng Lian & Ta-Wen Hsu & Ching-Chih Lee, 2012. "The Combined Effect of Individual and Neighborhood Socioeconomic Status on Cancer Survival Rates," PLOS ONE, Public Library of Science, vol. 7(8), pages 1-10, August.
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    1. Wenjian Zhou & Jianming Hou & Meng Sun & Chang Wang, 2022. "The Impact of Family Socioeconomic Status on Elderly Health in China: Based on the Frailty Index," IJERPH, MDPI, vol. 19(2), pages 1-14, January.

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