Sphincterpreservation in rectal cancer is associated with patients' socioeconomic status: F03

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Aim:The choice of operation for rectal cancer is complex. In addition to clinical factors, we hypothesized the socioeconomic background influences the decision.Method:Data on civil status, education and income were linked to the Swedish Rectal Cancer Registry 1995-2005 (n = 16 713) and analysed by logistic regression, adjusting for age, sex, stage, distance from the anal verge, type of hospital and region.Results:Unmarried patients were least likely (OR 0.76; 95% CI 0.64-0.88) and university educated men most likely (OR 1.30; 1.04-1.62) to have an anterior resection (AR). Patients with the highest income (Q4) had an AR more often than all others (OR income Q1 0.80; 0.69-0.94, income Q2 0.85; 0.73-0.98 and income Q3 0.86; 0.75-0.98). Uiniversity educated patients were least likely to have an abdominoperineal resection (OR 0.78; 0.63-0.98).Conclusion:The choice of operation for rectal cancer is not socio-economically neutral. Factors including comorbidity and smoking may explain the differences to some extent but inequality in the ‘quality of treatment is also possible.

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