10565 Background: Socioeconomic factors have been identified to influence patterns of care in colorectal cancer yet current literature findings are sparse, conflicting, and often incomplete. As such, this study investigates the impact of socioeconomic status (SES) on stage at presentation, receipt of diagnostic imaging, receipt of treatment, and overall survival (OS) in a universal healthcare system. Methods: The Ontario Cancer Registry was accessed to identify a cohort of patients diagnosed with colorectal adenocarcinoma from 2007-2016 in Ontario, Canada. Linkage to administrative datasets allowed study of the impact of SES, measured by mean neighbourhood household income divided into quintiles (Q1-Q5; Q1 = lowest income), on stage, imaging, treatments, and OS. Multivariable regression analyses of all endpoints were adjusted for age, sex, comorbidity, and rurality with OS models also adjusting for imaging and treatment. Results: 39,802 colon and 13,164 rectal patients were identified. Lower SES patients were more likely to present at a higher stage in both cohorts. Lower SES colon patients were less likely to receive magnetic resonance imaging (MRI) of the abdomen, liver resection, adjuvant oxaliplatin, and all palliative systemic therapies studied. In rectal patients, lower SES was associated with decreased receipt of MRI pelvis, rectal cancer resection in early stages, adjuvant oxaliplatin, and most palliative chemotherapies studied. All OS models found that lower SES was associated with poorer OS. Conclusions: These findings suggest disparities across the continuum of cancer care persist even within a universal healthcare system. Further efforts should be directed towards temporal research, identifying barriers, and subsequently applying this information to actionable policies.
Liver Immune Microenvironment and Metastasis from Colorectal Cancer-Pathogenesis and Therapeutic Perspectives
