title: Socioeconomic factors impact colon cancer outcomes in diverse patient populations.
abstract: OBJECTIVE
  Cancer disparities among racial and ethnic groups are major public health concerns. Our objective was to examine the impact of socioeconomic status (SES) on survival of colon cancer patients within major racial and ethnic groups.
  
  
  METHODS
  Patients with colon adenocarcinoma from Los Angeles County (LAC) were assessed. SES was utilized as an indicator of healthcare access and categorized by tertiles (high, middle, and low). Patient characteristics were compared and survival analyses were performed.
  
  
  RESULTS
  In our heterogeneous LAC cohort, we confirmed survival disparities. Asians had the best survival followed by Hispanics, whites, and blacks. For each stage of disease, Asians and Hispanics had better outcomes than whites and blacks. Then, we evaluated the impact of SES on survival within each racial and ethnic group. We observed significantly longer survival for high SES patients compared to middle and low SES patients for all racial/ethnic groups.
  
  
  CONCLUSIONS
  While disparities across racial/ethnic groups are well-documented, our study is the first to identify socioeconomic disparities in survival for patients within the same group. These novel findings demonstrate the complex role of SES on race and ethnicity and identify the need to improve healthcare access even within select populations.
authors.affiliation: Department of Oncologic Surgery, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA 91010, USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: Lee
authors.forename: Rebecca
authors.initials: R
authors.lastname: Nelson
authors.forename: Brian
authors.initials: B
authors.lastname: Mailey
authors.forename: Marjun Philip
authors.initials: MP
authors.lastname: Duldulao
authors.forename: Julio
authors.initials: J
authors.lastname: Garcia-Aguilar
authors.forename: Joseph
authors.initials: J
authors.lastname: Kim
mesh_terms: D000230:Adenocarcinoma / Q000191:economics* / Q000208:ethnology; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data; D003110:Colonic Neoplasms / Q000191:economics* / Q000208:ethnology; D005260:Female; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000191:economics*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012923:Social Class; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data