The influence of socioeconomic position on adjuvant treatment of stage III colon cancer: a systematic review and meta-analysis

Figures & data

Figure 1. Flow diagram over literature search and included studies.

Table 1. Baseline characteristics of included trials, SEP indicators and use of adjuvant chemotherapy.

Author	Publication year	Country	Inclusion period	No. patients included	Received ACT	SEP indicators	SEP level
Studies including patients with resected stage III CC
Sarasqueta [53]	2019	Es	2010–2012	654	Age <65: 92% Age 65-80: 77% Age >80: 27%	Education Poverty	Individual Census tract
Ortiz-Ortiz [31]	2018	US	2008–2012	1035	75%	Insurance	Individual
Guerrero [52]	2018	US	2005–2014	438	63%	Income Insurance Employment	Zip code Individual Individual
Ahmed [32]	2018	US	2004–2012	130,998	NR	Insurance	Individual
Gao [33]	2018	US	1992–2008	18,491	53%	Income Education	NR
Sparling [44]	2016	US	1999–2002	692	43%	Poverty	Census block
Booth [34]	2016	Ca	2002–2008	2801	66%	Income	Residence codes (9000 inhabitants)
Hsieh [30]	2016	US	2011	3180	64%	Insurance Poverty	Individual Census tract
Murphy [28]	2015	US	1990–2010	1219	65%	Insurance	Individual
Upadhyay [29]	2015	US	2000–2010	196,412	62%	Insurance Income Education	Individual Zip-code
Panchal [35]	2013	US	2003–2005	4106	50%	Income	Census tract
Merkow [48]	2013	US	2006–2008	2368	63.2%	Income	NR
van der Geest [50]	2013	NL	2006–2008	606		SEP index	Postal code
Cavalli-Bjorkman [45]	2011	S	1997–2006	5715	75%	Education	Individual
Lima [47]	2011	Ca	2000–2005	1053	61%	Income Employment Education	Dissemination area
Van Steenbergen [40]	2010	NL	2001–2007	1637	63%	SEP index	Postal code
Winget [36]	2010	Ca	2002–2005	772	63%	Income Employment Education	Area (600 households)
Luo [42]	2006	US	1992–1999	7569	59%	Poverty	Census tract (4000 inhabitants)
McGory [43]	2006	US	1994–2001	13,231	48%	Poverty	Census tract
Lemmens [39]	2005	NL	1995–2001	577	50%	SEP index	Area (17 households)
Wu [51]	2004	US	2001	303	66%	Insurance Poverty	Individual / Counties
VanEenwyk [27]	2002	US	1996–1997	632	62%	Insurance Income	Individual / Zip-code
Schrag [38]	2001	US	1991–1996	6262	55%	Income	Census tract (4000 inhabitants)
Studies including patients with resected tumour and oncological assessment
Baldwin [41]	2015	US	1992–1996	5294	59% black 70% white 59% black 70% white	Income Education	Census tract (4000 inhabitants) Census tract (4000 inhabitants)
Massarweh [49]	2015	US	2003–2010	51,331	100%	Income Education	Area (2000 inhabitants)
El Shayeb [37]	2012	Ca	2002–2005	613	75%	Income Education	Neighborhood
Hershman [46]	2006	US	1992–1999	4382	100%	SEP index	Zip code

ACT: adjuvant chemotherapy; Ca: Canada; Es: Spain; NL: Netherlands; NR: not reported; S: Sweden; SEP: Socioeconomic position; US: United States of America.

Figure 2. Meta-analyses of receiving adjuvant chemotherapy in low versus high socioeconomic position among patients with resected stage III colon cancer (CC) (A–F) and stage III CC patients with an oncological assessment (G,H). CC: colon cancer; CI: confidence interval; OR: odds ratio; SEP: socioeconomic position.

Figure 3. Meta-analyses of odds of delayed initiation of chemotherapy (A) and of initiation of combination chemotherapy (B) in low versus high socioeconomic position (SEP) among stage III colon cancer patients. OR: odds ratio; CI: confidence interval; SEP: socioeconomic position.