The Impact of Socioeconomic Status on Mortality in Patients with Hepatocellular Carcinoma: A Korean National Cohort Studyopen accessThe Impact of Socioeconomic Status on Mortality in Patients with Hepatocellular Carcinoma: A Korean National Cohort Study
- Other Titles
- The Impact of Socioeconomic Status on Mortality in Patients with Hepatocellular Carcinoma: A Korean National Cohort Study
- Authors
- Yang, Woo Jin; Kang, Danbee; Song, Myung Gyu; Seo, Tae-Seok; Kim, Ji Hoon
- Issue Date
- 2022
- Publisher
- EDITORIAL OFFICE GUT & LIVER
- Keywords
- Carcinoma; hepatocellular; Mortality; Social class; Socioeconomic status
- Citation
- GUT AND LIVER, v.16, no.6, pp.976 - 984
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- GUT AND LIVER
- Volume
- 16
- Number
- 6
- Start Page
- 976
- End Page
- 984
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/146064
- DOI
- 10.5009/gnl210567
- ISSN
- 1976-2283
- Abstract
- Background/Aims: We studied the impact of socioeconomic status (SES) on mortality in hepa-tocellular carcinoma patients and analyzed the effect of SES on initial treatment allocation. Methods: A cohort study was conducted using data from the National Health Insurance Service-National Sample Cohort of Korea. A total of 3,032 hepatocellular carcinoma patients who were newly diagnosed between January 2003 and December 2013 were included. Income level was categorized as Medical Aid and <= 30th, 31st-70th, or >70th percentile as an SES indicator. Results: The proportion of Medical Aid was 4.3%. The highest risks of all-cause mortality associ-ated with Medical Aid were evident in the transcatheter arterial chemoembolization group (fully adjusted hazard ratio [HR], 2.40; 95% confidence interval [CI], 1.25 to 4.58), the other treatments group (fully adjusted HR, 2.86; 95% CI, 1.85 to 4.41), and the no treatment group (fully adjusted HR, 2.69; 95% CI, 1.79 to 4.04) but not in the curative treatment group. An association between the lower-income percentile and higher liver cancer-specific mortality was also observed, except in the curative treatment group. The association between income percentile and all-cause mortal-ity was nonlinear, with a stronger association in the lower-income percentiles than in the higher income percentiles (p-value for nonlinear spline terms <0.05). Conclusions: Patients in the lower SES group, especially patients not eligible for curative treat-ment, had an increased risk of mortality. In addition, the association between SES and the risk for mortality was stronger in the lower-income percentile than in the moderate to higher income percentiles. (Gut Liver, Published online April 22, 2022)
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