The Association of Social Vulnerability and Area Deprivation With Open Versus Laparoscopic Partial Colectomy for Colon Cancer

Abstract

Introduction

Comparisons between open and laparoscopic partial colectomy for colon cancer are well documented. Social vulnerability (SVI) and area deprivation (ADI) indices reflect social determinants of health, often associated with worse surgical outcomes. Here we examine the association of SVI and ADI with partial colectomy approach.

Methods

Data came from the Epic Cosmos database for patients with colon cancer who underwent partial colectomy between 2013 and 2022. Only patients with documented SVI were included. Descriptive statistics and binary logistic regression were performed.

Results

This study included 41,158 patients with colon cancer, of which 18,446 patients underwent open and 22,712 patients underwent laparoscopic partial colectomy. White patients were more likely to undergo laparoscopic colectomy than Black patients (OR: 1.11, 95% CI 1.05-1.17, P < .001). Thirty-day and 12-month mortality were higher in the open (4.7% and 14.5%) than laparoscopic group (1.0% and 4.9%). Upper quartile SVI and ADI had higher odds of open surgery (OR: 1.24, 95% CI 1.18-1.30, P < .001; OR: 1.45, 95% CI 1.39-1.52, P < .001, respectively).

Conclusion

Upper quartile SVI and ADI had higher odds of open partial colectomy for colon cancer. Clinical presentation and stage at diagnosis largely dictate the approach. Increasing CRC awareness and screenings while promoting laparoscopic partial colectomy would benefit populations with high social vulnerability and area deprivation.