Impact of Socioeconomic Status on Cancer Incidence Risk, Cancer Staging, and Survival of Patients with Colorectal Cancer under Universal Health Insurance Coverage in Taiwan

Wei-Yin Kuo, Han-Sheng Hsu, Pei-Tseng Kung and Wen-Chen Tsai
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Wei-Yin Kuo: Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan
Han-Sheng Hsu: Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan
Pei-Tseng Kung: Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan
Wen-Chen Tsai: Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan

IJERPH, 2021, vol. 18, issue 22, 1-17

Abstract: This study examined the impact of socioeconomic status on colorectal cancer risk, staging, and survival under the National Health Insurance (NHI) system in Taiwan. Monthly salary and education level were used as measures of socioeconomic status to observe the risk of colorectal cancer among individuals aged 40 years or above in 2006–2015 and survival outcomes of patients with colorectal cancer until the end of 2016. Data from 286,792 individuals were used in this study. Individuals with a monthly salary ≤Q1 were at a significantly lower incidence risk of colorectal cancer than those with a monthly salary >Q3 (HR = 0.80, 95% CI = 0.74–0.85), while those with elementary or lower education were at a significantly higher risk than those with junior college, university, or higher education (HR = 1.18, 95% CI = 1.06–1.31). The results show that socioeconomic status had no significant impact on colorectal cancer stage at diagnosis. Although salary was not associated with their risk of mortality, patients with colorectal cancer who had elementary or lower education incurred a significantly higher risk of mortality than those who had junior college, university, or higher education (HR = 1.39, 95% CI = 1.07–1.77). Education level is a significant determinant of the incidence risk and survival in patients with colorectal cancer, but only income significantly impacts incidence risk.

Keywords: colorectal cancer; socioeconomic status; cancer stage; risk of mortality; survival analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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