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The Combined Effect of Individual and Neighborhood Socioeconomic Status on Nasopharyngeal Cancer Survival

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  • Ting-Shou Chang
  • Chun-Ming Chang
  • Ta-Wen Hsu
  • Yaoh-Shiang Lin
  • Ning-Sheng Lai
  • Yu-Chieh Su
  • Kuang-Yung Huang
  • Hung-Lung Lin
  • Ching-Chih Lee

Abstract

Background: The relationship between individual and neighborhood socioeconomic status (SES) and mortality rates in patients with nasopharyngeal carcinoma (NPC) is unknown. This population-based study aimed to examine the association between SES and survival of patients with NPC in Taiwan. Materials and Methods: A population-based follow-up study was conducted of 4691 patients diagnosed with NPC between 2002 and 2006. Each patient was traced to death or for 5 years. Individual SES was defined by enrollee job category. Neighborhood SES was based on household income dichotomized into advantaged and disadvantaged areas. Cox proportional hazards model was used to compare the death-free survival rates between the different SES groups after adjusting for possible confounding factors and risk factors. Results: In NPC patients below the age of 65 years, 5-year overall survival rates were worst for those with low individual SES living in disadvantaged neighborhoods. After adjusting for patient characteristics (age, gender, Charlson Comorbidity Index Score), NPC patients with low individual SES residing in disadvantaged neighborhoods were found to have a 2-fold higher risk of mortality than patients with high individual SES residing in advantaged neighborhoods. We found no significant difference in mortality rates between different SES groups in NPC patients aged 65 and above. Conclusions: Our findings indicate that NPC patients with low individual SES who live in disadvantaged neighborhoods have the higher risk of mortality than their more privileged counterparts. Public health strategies and welfare policies would be well advised to try to offset the inequalities in health care and pay more attention to addressing the needs of this vulnerable group.

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  • Ting-Shou Chang & Chun-Ming Chang & Ta-Wen Hsu & Yaoh-Shiang Lin & Ning-Sheng Lai & Yu-Chieh Su & Kuang-Yung Huang & Hung-Lung Lin & Ching-Chih Lee, 2013. "The Combined Effect of Individual and Neighborhood Socioeconomic Status on Nasopharyngeal Cancer Survival," PLOS ONE, Public Library of Science, vol. 8(9), pages 1-9, September.
    • Handle: RePEc:plo:pone00:0073889
    DOI: 10.1371/journal.pone.0073889
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    References listed on IDEAS

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    1. Kim, Jinyoung & Durden, Emily, 2007. "Socioeconomic status and age trajectories of health," Social Science & Medicine, Elsevier, vol. 65(12), pages 2489-2502, December.
    2. Roohan, P.J. & Bickell, N.A. & Baptiste, M.S. & Therriault, G.D. & Ferrara, E.P. & Siu, A.L., 1998. "Hospital volume differences and five-year survival from breast cancer," American Journal of Public Health, American Public Health Association, vol. 88(3), pages 454-457.
    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. Ching-Chih Lee & Ting-Shou Chang & Cheng-Jung Wu & Ching-Chieh Yang & Po-Chun Chen, 2015. "Determinants of End-of-Life Expenditures in Patients with Oral Cancer in Taiwan: A Population-Based Study," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-10, May.

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