Socioeconomic status as a predictor of adherence to treatment guidelines for XXXX .

@entity43 @entity1 @entity31986 @entity5 @entity16420 @entity31985 @entity34
OBJECTIVE: Investigate the impact of socioeconomic status and other demographic variables on adherence to the National @entity43 treatment guidelines among @entity1 with stage I/II disease. METHODS: @entity1 diagnosed with @entity43 between 1/1/96-12/31/06 were identified from the California @entity5 Registry. Univariate analysis and multivariate logistic regression models were used to evaluate differences in surgical procedures, chemotherapy regimens, and overall adherence to the NCCN guidelines according to increasing SES quintiles ( @entity16420 to SES-5). RESULTS: A total of 5445 stage I and II @entity1 were identified. The median age at diagnosis was 54.0years (range=18-99years); 72.5% of @entity1 had stage I disease, while 27.5% had @entity34 . With a median follow-up time of 5years, the 5-year @entity43 -specific survival for all @entity1 was 82.7% (SE=0.6%). Overall, 23.7% of @entity1 received care that was adherent to the NCCN guidelines. Compared to @entity1 in the highest SES quintile (SES-5), @entity1 in the lowest SES quintile ( @entity16420 ) were significantly less likely to receive proper surgery (27.3% vs 47.9%, p<0.001) or chemotherapy (42.4% vs 53.6%, p<0.001). There were statistically significant trends between increasing SES and the likelihood of overall treatment plan adherence to the NCCN guidelines: @entity16420 =16.4%, @entity31985 =19.0%, @entity31986 =22.4%, SES-4=24.2% and SES-5=31.6% (p<0.001). Multivariate logistic regression analysis revealed that compared to SES-5, decreasing SES was independently predictive of a higher risk of non-standard overall care. CONCLUSIONS: For @entity1 with @entity43 , low SES is a significant and independent predictor of deviation from the NCCN guidelines for surgery, chemotherapy, and overall treatment.
