Influence of Socioeconomic Status, Comorbidity, and Disability on Late-stage Cancer Diagnosis

ABSTRACT

OBJECTIVES: Understanding factors affecting advanced stage at diagnosis is vital to improve cancer outcomes and overall survival. We investigated the factors affecting later-stage cancer diagnosis. METHODS: Patients completed self-reported questionnaires. We collected cancer stage data from medical records review. Logistic regression analyses were performed to identify factors associated with later stage cancer at diagnosis by gender. RESULTS: In total, 1,870 cancer patients were included in the study; 55.8% were men, 31.1% had more than one comorbid condition, and 63.5% had disabilities. About half of the patients were smokers, and drank alcohol, and 58.0% were diagnosed at an advanced stage. By cancer type, lung and liver cancers (both genders), prostate (men), colorectal, cervical, and thyroid cancer (women) were more likely to be diagnosed at a later stage. After controlling for socioeconomic factors, comorbidity (odds ratio [OR], 1.48 in men) and disability (OR, 1.64 in men and 1.52 in women) remained significantly associated with late-stage diagnosis. CONCLUSION: In this nationwide study, using combined information from patients and medical records, we found that male patients with comorbidities or disabilities, and female patients with disabilities were more likely to have advanced stage cancer at diagnosis. Targeted approaches by cancer type and health conditions are recommended.