The impact of income on clinical outcomes in FIGO stages I to II endometrioid adenocarcinoma of the uterus.
OBJECTIVE
To determine the influence of income on clinical outcomes in patients with surgical stages I to II endometrioid adenocarcinoma of the uterus.


METHODS
We retrospectively analyzed the records of 660 women initially treated from 1985 to 2009. On the basis of income data obtained from the 2000 US census, patients were separated into various income groups (halves, tertiles, and quartiles) based on median household income, with most focus on the half income groups.


RESULTS
Income groups were similar regarding treatments received and characteristics, with the exception of more African American (AA), unmarried patients, and a predilection for higher grade in the lower half income group (LHIG). Compared with the upper half income group (UHIG), the LHIG had lower disease-specific survival (DSS) (5 y: 93.9% vs. 97.0% and 10 y: 90.1% vs. 95.9%; P=0.023) and a trend toward lower overall survival (OS) (5 y: 83.4% vs. 86.5% and 10 y: 62.6% vs. 68.5%; P=0.067). In patients with higher-risk features, differences in outcomes between LHIG and UHIG were more pronounced; 10-year OS of 43.4% versus 60.2% (P=0.004) and 10-year DSS of 75.0% versus 93.0% (P=0.007), respectively. Regarding race, AA patients in the LHIG had lower OS than AA in the UHIG. On univariate analysis, income group and race were significant predictors for DSS, but on multivariate analysis, they were not statistically significant.


CONCLUSIONS
Despite similar treatments and characteristics, a small decrease in DSS and a trend toward reduced OS was observed in LHIG patients, but income group was not statistically significant on multivariate analysis of outcome. These differences were more significant in patients with high-risk features.
*Department of Radiation Oncology †Department of Public Health Sciences ‡Department of Women's Health Services, Division of Gynecologic Oncology, Henry Ford Hospital, Detroit, MI.
Jared R
JR
Robbins
Meredith G
MG
Mahan
Richard J
RJ
Krajenta
Adnan R
AR
Munkarah
Mohamed A
MA
Elshaikh
D018269:Carcinoma, Endometrioid / Q000191:economics* / Q000208:ethnology / Q000401:mortality / Q000601:surgery*; D015331:Cohort Studies; D016889:Endometrial Neoplasms / Q000191:economics* / Q000208:ethnology / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007182:Income; D053208:Kaplan-Meier Estimate; D016896:Treatment Outcome; D014481:United States