Table 3.
Adjusted odds ratios of being offered surgery (with or without chemoradiation), compared to no treatment or definitive chemoradiation across racial and socioeconomic population groups, among nonmetastatic adult esophageal cancer cases, stratified by clinical cancer stage
| Stage I | Stage II | Stage III | |
|---|---|---|---|
| OR (95% CI)† | OR (95% CI)† | OR (95% CI)† | |
| Race | |||
| White | REF | REF | REF |
| Black | 0.39 (0.33, 0.46) | 0.47 (0.42, 0.53) | 0.39 (0.35, 0.43) |
| Other | 1.03 (0.77, 1.38) | 0.80 (0.65, 0.97) | 0.58 (0.49, 0.69) |
| Sex | |||
| Male | REF | REF | REF |
| Female | 0.77 (0.70, 0.85) | 0.72 (0.67, 0.77) | 0.70 (0.65, 0.75) |
| Primary insurance | |||
| Private | REF | REF | REF |
| Medicaid | 0.62 (0.51, 0.75) | 0.53 (0.46, 0.61) | 0.48 (0.43, 0.54) |
| Medicare | 0.85 (0.77, 0.94) | 0.67 (0.62, 0.72) | 0.72 (0.67, 0.77) |
| Uninsured | 0.36 (0.27, 0.47) | 0.43 (0.36, 0.52) | 0.36 (0.31, 0.42) |
| Travel distance, miles | |||
| <5 miles | REF | REF | REF |
| 5–11.9 miles | 1.26 (1.13, 1.41) | 1.14 (1.05, 1.24) | 1.13 (1.05, 1.23) |
| 12–31.9 miles | 1.60 (1.42, 1.79) | 1.45 (1.33, 1.58) | 1.39 (1.28, 1.50) |
| ≥32 miles | 4.01 (3.57, 4.51) | 2.80 (2.56, 3.07) | 2.45 (2.26, 2.66) |
| Median household income ‡ | |||
| ≥$63,000 | REF | REF | REF |
| $48,000–$62,999 | 0.93 (0.83, 1.05) | 0.89 (0.81, 0.97) | 0.95 (0.87, 1.02) |
| $38,000–$47,999 | 0.82 (0.72, 0.94) | 0.83 (0.75, 0.92) | 0.90 (0.83, 0.99) |
| <$38,000 | 0.80 (0.68, 0.94) | 0.70 (0.61, 0.79) | 0.83 (0.74, 0.93) |
| Education, % without high school degree§ | |||
| <7% | REF | REF | REF |
| 7%–12.9% | 0.84 (0.74, 0.94) | 0.92 (0.84, 1.01) | 0.87 (0.81, 0.94) |
| 13%–20.9% | 0.67 (0.58, 0.77) | 0.84 (0.75, 0.93) | 0.77 (0.71, 0.85) |
| ≥21% | 0.54 (0.46, 0.64) | 0.76 (0.66, 0.86) | 0.61 (0.54, 0.69) |
†Adjusted for clinical cancer stage, year of diagnosis, age (modeled as a restricted cubic spline), sex, Charlson–Deyo score, race, primary insurance, travel distance to hospital, median household income, and education; interaction terms between clinical cancer stage and race, sex, primary insurance, travel distance, median household income, and education were used to get stage-stratified estimates.
‡ Median residential household income of each patient's ZIP code was estimated using the 2012 American Community Survey.
§Proportion of adults in patient's ZIP code who did not complete high school, measured in the 2012 American Community Survey.