Department of Radiology, Oncology and Radiation Science, Uppsala University, 751 85 Uppsala, Sweden.
Br J Cancer. 2012 Jun 26;107(1):189-94. doi: 10.1038/bjc.2012.186. Epub 2012 May 10.
Socioeconomic status (SES) and social support influences cancer survival. If SES and social support affects cancer treatment has not been thoroughly explored.
A cohort consisting of all patients who were initially diagnosed with or who developed metastatic colorectal cancer (mCRC, n=781) in three Scandinavian university hospitals from October 2003 to August 2006 was set up. Clinical and socioeconomic data were registered prospectively.
Patients living alone more often had synchronous metastases at presentation and were less often treated with combination chemotherapy than those cohabitating (HR 0.19, 95% CI 0.04-0.85, P=0.03). Surgical removal of metastases was less common in patients living alone (HR 0.29, 95% CI 0.10-0.86, P=0.02) but more common among university-educated patients (HR 2.22, 95% CI 1.10-4.49, P=0.02). Smoking, being married and having children did not influence treatment or survival. Median survival was 7.7 months in patients living alone and 11.7 months in patients living with someone (P<0.001). Living alone remained a prognostic factor for survival after correction for age and comorbidity.
Patients living alone received less combination chemotherapy and less secondary surgery. Living alone is a strong independent risk factor for poor survival in mCRC.
社会经济地位（SES）和社会支持会影响癌症的生存情况。SES 和社会支持是否会影响癌症的治疗尚未得到充分的探究。
建立了一个队列，其中包括 2003 年 10 月至 2006 年 8 月期间在三家斯堪的纳维亚大学医院首次诊断或发展为转移性结直肠癌（mCRC）的所有患者（n=781）。前瞻性地登记了临床和社会经济数据。
独居的患者在就诊时更常出现同步转移，且接受联合化疗的比例低于同居患者（HR 0.19，95% CI 0.04-0.85，P=0.03）。独居患者接受转移灶切除术的比例较低（HR 0.29，95% CI 0.10-0.86，P=0.02），而受教育程度较高的患者接受手术的比例较高（HR 2.22，95% CI 1.10-4.49，P=0.02）。吸烟、已婚和有子女并不会影响治疗或生存。独居患者的中位生存时间为 7.7 个月，与同居患者的 11.7 个月相比（P<0.001）。在调整年龄和合并症后，独居仍然是 mCRC 患者生存的预后因素。
独居患者接受的联合化疗和辅助手术较少。独居是 mCRC 患者生存不良的一个独立危险因素。
