No effect of comorbidities on the association between social deprivation and geographical access to the reference care center in the management of colon cancer.

BACKGOUND

Patients with colon cancer in France exhibit one of the steepest socioeconomic survival gradients in Europe. Among the putative causes for this situation, comorbidities are frequently incriminated but evidence of this is lacking.

AIMS

Measure the influence of social deprivation and geographical access to the reference care center for the management of colon cancer, and the putative role of associated comorbidities.

MATERIALS AND METHODS

The study population comprised all 1383 resected colon cancer cases diagnosed between 2005 and 2010 in the area covered by the "Calvados Registry of Digestive Tumors". Social environment was assessed by using the European Deprivation Index and travel time to the reference care center and comorbidities by using Charlson's comorbidity index.

RESULTS

Our results confirm the existence of socioeconomic or geographical inequalities at each step of colon cancer management, but without any role of associated comorbidities. The effect of deprivation is mainly explained by age at diagnosis, while travel time to the reference care center is an independent predictor of cancer management.

CONCLUSION

We found no effect of comorbidities on the association between socioeconomic factors and the management of colon cancer in this French department.