{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:35:59Z","timestamp":1789605359618,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>National social determinant of health (SDoH) studies on gastrointestinal cancers (GIC) have observed single GIC\u2010types for surgery but not across all GIC\u2010types, non\u2010surgical treatments outcomes, or mortality. The Social Vulnerability Index (SVI), a validated large\u2010data SDoH\u2010tool, quantifiably characterizes the interrelatedness of SDoH\u2010impact through dynamic, region\u2010contextualized measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study assessed GIC patients (20+ years) between 2013 and 2017 from the Surveillance, Epidemiology, and End Results (SEER) database for total and subcomponent social vulnerability associations across 15 SDoH\u2010variables encompassing themes of socioeconomic status, minority\u2010language status, household composition, and housing\u2010transportation measured by the Social Vulnerability Index (SVI). These are measured and contextualized from all US counties. Univariate logistic and linear regressions of these vulnerability associations with treatment receipt (chemotherapy, radiation, primary surgery) and survival were performed for the entire cohort and across race\/ethnicity strata.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>With increasing overall social vulnerability, 287,248 patients (162,387 [56.5%] male; 185,250 [64.6%] white) demonstrated decreased receipt of chemotherapy (lowest, pancreas\u2010OR, 0.90; 95% CI, 0.88\u20130.93), radiotherapy (hepatic\u2010OR, 0.87; 95% CI, 0.85\u20130.89) and surgery (esophagus\u2010OR, 0.90; 95% CI, 0.87\u20130.92) for 13\/14, 10\/14, and 8\/14 GIC\u2010types, respectively. Survival period decreases upwards of 21.3% (biliary tract: 6.9\u20135.4\u2009months) were observed across 7\/14 GICs. Treatment receipt and survival decreases were exacerbated for non\u2010White patients for 9\/14 GICs. Socioeconomic status, minority\u2010language, household composition, and housing\u2010transportation vulnerabilities differentially contributed to these trends.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Social vulnerability was associated with worse prognostic and treatment disparities, with certain SDoH\u2010types differentially contributing to these detrimental trends per GIC\u2010type while associations were exacerbated among non\u2010White race\/ethnic patients. These real\u2010world contexts present actionable targets for further initiatives to combat GIC disparities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.70591","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T18:36:35Z","timestamp":1741718195000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Associations of Social Vulnerability and Race\u2010Ethnicity With Gastrointestinal Cancers in the United States"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4485-8274","authenticated-orcid":false,"given":"David J.","family":"Fei\u2010Zhang","sequence":"first","affiliation":[{"name":"Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Bentrem","sequence":"additional","affiliation":[{"name":"Department of Surgery Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey D.","family":"Wayne","sequence":"additional","affiliation":[{"name":"Department of Surgery Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lifang","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Center for Global Oncology Robert J. 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Lurie Comprehensive Cancer Center of Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peiwen","family":"Fei","sequence":"additional","affiliation":[{"name":"University of Hawaii Cancer Center, University of Hawaii  Honolulu Hawaii USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7994-9870","authenticated-orcid":false,"given":"Timothy M.","family":"Pawlik","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Oncology The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.02.068"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605\u2010022\u201005496\u20106"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010023\u201013122\u20101"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2022.04.019"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055\u20109965.EPI\u201020\u20100950"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.5664"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jnma.2022.04.001"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010023\u201013339\u20100"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3978\/j.issn.2078\u20106891.2015.039"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010023\u201013449\u20109"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djad164"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2020.5554"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2021.02.038"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.15001"},{"key":"e_1_2_9_17_1","unstructured":"ATSDR \u201cCDC SVI Documentation 2018. 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