274. The postcode lottery: Effects on colorectal cancer stage and long term survival

Introduction: Colorectal cancer outcomes vary in the U.K between centres, with patients from deprived backgrounds presenting at an advanced stage, having poor long term survival. Our aim was to analyse the outcome of patients undergoing curative colorectal (CRC) resections based on their socioeconomic status (SES). Methods: Data from a prospectively constructed database between years 2006-2010 was analyzed. Primary endpoints were 30-day mortality and presentation stage with secondary endpoints being long term survival. Socioeconomic status was determined from postcode using UK geodemographic database providers. Results: A total of 662 patients undergoing curative CRC resections were identified. Colonic resections accounted for 57.5% (n1⁄4380) compared to 42.5% (n1⁄4282) of rectal resections. Dukes C stage cancers comprised of 47.1% of patients (n1⁄4312).Thirty-day mortality was 3.8% with an overall median survival of 75 months for all patients. On the basis of SES, patients were divided into 3 groups: high (10.2%), middle (32.8%) and low (57%). No significant survival benefit was seen between patients from different SES (p1⁄40.78, Mantel-cox). When stage at presentation was compared, patients from a high SES (23.1%) were more likely to present at an earlier stage compared to those from low SES (14.4%) (p1⁄40.03 Chisquare Test). Overall 30-day mortality was 4.1% (n1⁄427/662), being significantly lower in patients from a higher SES compared to those from a lower SES (n1⁄42/27 vs. n1⁄417/27). Conclusions: Patients from a low SES tend to present at a more advanced disease stage, having a significantly higher 30-day mortality compared to patients from a high SES. In our study, the overall survival was not affected by socioecomonic status contrary to what is stated in the literature. No conflict of interest.