title: Socioeconomic status, p53 abnormalities, and colorectal cancer.
abstract: BACKGROUND
  Low socioeconomic status (SES) has been associated with abnormal expression of p53 in breast cancer, but this relationship has not been evaluated for colorectal cancer (CRC). A cohort of CRC patients was evaluated to determine if SES is associated with abnormal p53 expression.
  
  
  METHODS
  The study population consisted of 249 patients who underwent curative or palliative resections for CRCs at the University of Alabama at Birmingham Hospital. Measures of SES and potential confounders were abstracted from medical records. Abnormal nuclear accumulation of p53 (p53(nac)) was measured in CRCs by immunohistochemistry. Logistic regression was used to assess the relationship between low SES and p53(nac).
  
  
  RESULTS
  Over half (56.2%) of the patients exhibited p53(nac) in their CRCs. After adjustment, the odds ratio for p53(nac) was 1.28 (95% CI =0.55, 2.99) for Medicaid patients relative to those without Medicaid coverage. There was no association between the prevalence of p53(nac) and unemployment, private insurance coverage, or having Medicare due to disability.
  
  
  CONCLUSIONS
  The odds of having p53(nac) were 1.28 times higher for patients with Medicaid coverage, although these findings were not statistically significant. The results of this pilot study, however, provide evidence of a molecular basis for the decreased survival of low SES patients with CRC.
authors: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, AL, USA;
authors: Emily
authors: E
authors: Vogtmann
authors: Chandrakumar
authors: C
authors: Shanmugam
authors: Venkat R
authors: VR
authors: Katkoori
authors: John
authors: J
authors: Waterbor
authors: Upender
authors: U
authors: Manne
keywords: Colorectal cancer; employment status; health insurance; p53 abnormalities; socio economic status