Christina M. Lineback, BS, Colin M. Mervak, BA, Sha’shonda L

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Barriers to Accessing Optimal Esophageal Cancer Care for Socioeconomically Disadvantaged Patients Christina M. Lineback, BS, Colin M. Mervak, BA, Sha’shonda L. Revels, MD, MS, Micheal T. Kemp, BS, Rishindra M. Reddy, MD The Annals of Thoracic Surgery Volume 103, Issue 2, Pages 416-421 (February 2017) DOI: 10.1016/j.athoracsur.2016.08.085 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Treatment patterns. Only 44.7% of patients with low socioeconomic status (SES) were offered surgical treatment compared with 76.3% of the high-SES population (**p = 0.0048). Chemotherapy was offered equally to the 2 groups (83%; p = 1). Similarly, there was no significant difference in the amount of radiation offered: low SES (57.9%); high SES (52.6%); p = 0.64552. The Annals of Thoracic Surgery 2017 103, 416-421DOI: (10.1016/j.athoracsur.2016.08.085) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Communication barriers. Second opinions, treatment understanding, and loss in trust were lower in the low–socioeconomic status (SES) groups (23.8%, 61.9%, and 50%, respectively) versus the high-SES group (65.8%, 83.8%, and 15%, respectively). **p = 0.00002; ***p = 0.031; *p = 0.046. The Annals of Thoracic Surgery 2017 103, 416-421DOI: (10.1016/j.athoracsur.2016.08.085) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Financial barriers. Educational disparity and loss of employment in patients with low socioeconomic status (SES) (43% and 33.3%, respectively) versus patients with high SES (71% and 2.6%, respectively) (*p = 0.0136; **p = 0.0004). Differences in financial difficulties between low SES (66.6%) and high SES (47.7%) were not significant (p = 0.08186). The Annals of Thoracic Surgery 2017 103, 416-421DOI: (10.1016/j.athoracsur.2016.08.085) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions