Poverty and anal cancer: is there a survival correlation?

ABSTRACT NUMBER: NESTAC_15

 

AUTHORS
Farah Mahmoud Ali, Ali Ghareeb, D Garg, Hans Van der Voet, Madan Jha

AFFILIATIONS
James Cook University Hospital

CORRESPONDING AUTHOR CONTACT EMAIL
moc.liamg@akzf.haraf

 

MAIN ABSTRACT TEXT

Introduction
Squamous cell carcinoma (SCC) is the commonest variant of the rather uncommon anal malignancy. Certain disease-related factors have been established in determining survival. These include tumour size, differentiation and nodal involvement. Other factors such as HIV status, HPV infection, smoking and socioeconomic disparity may have important roles however, little data is available on the UK population. We aim to correlate social deprivation and survival of anal cancer patients at a tertiary centre.

Methods
All patients diagnosed with anal SCC and treated as per local protocol between July 2010 and April 2017 were included. The pathological and demographical details were collected from a prospective database. Socioeconomic deprivation was defined for each postcode using the Index of Multiple Deprivation decile compiled by local governments in England. Survival was estimated using Kaplan-Meier analysis and Cox regression was used to investigate the effect of different factors on overall survival.

Results
One hundred twenty-nine patients with a median follow up of 43 months were included. Overall five survival rate amongst relatively affluent (66.7%) and deprived quintiles (68.5%) was not significant (p = 0.43). On multivariate analysis, increased risk of death was observed for older age at presentation (HR, 1.42; 95% CI 1.04 – 1.93, p = 0.024) and larger tumours (HR, 1.51; 95% CI 1.06 – 2.14, p = 0.021).

Conclusion
In contrast to the published US studies, we have found similar survival outcomes among groups of different socioeconomic status with higher overall survival. This may reflect the uniformity of the access to healthcare for all in the UK