Socioeconomic Gradients Measured by the Yost Index and Colorectal Cancer Outcomes: A SEER-Medicare Analysis.

Cohort studyJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract· Jul 2026

Socioeconomic Gradients Measured by the Yost Index and Colorectal Cancer Outcomes: A SEER-Medicare Analysis.

Eshetu B Worku, Selamawit A Woldesenbet, Timothy M Pawlik

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Colon & Rectal SurgeryCohort studyClinical practiceQ2IF 2.0

Lower neighborhood socioeconomic status linked to higher 90-day mortality after colorectal cancer surgery.

Socioeconomic Gradients Measured by the Yost Index and Colorectal Cancer Outcomes: A SEER-Medicare Analysis.

Eshetu B Worku … Timothy M Pawlik

Journal of gastrointestinal surgery · Jul 2026 · Q2 in Gastroenterology

Background

Neighborhood socioeconomic context influences access to colorectal cancer (colorectal cancer) care and outcomes, yet its independent contribution to short-term surgical outcomes remains unclear.

Purpose

This study evaluated associations between neighborhood level Yost socioeconomic status (socioeconomic status) and urgent presentation and short-term outcomes among older adults undergoing colorectal cancer surgery.

Methods

Medicare beneficiaries aged 66-90 years who underwent colectomy or rectal resection for malignant colorectal cancer were identified from SEER-Medicare data (2006-2019).

n = 72,491 patients

Results

lower-income neighborhood patients faced lower 90-day survival odds

OR by subgroup · 95% CI

More results

Among 72,491 patients (77.4% colon; 22.6% rectal), lower neighborhood socioeconomic status was associated with more acute presentation and worse short-term outcomes.

Emergency diagnosis occurred more frequently in the lowest versus highest socioeconomic status quintile (16.7% vs 11.6%), and 90-day mortality was higher (11.0% vs 7.5%).

More results

Urgent presentation strongly predicted complications (OR 2.35; 95% CI 2.24-2.46) and mortality (OR 4.88; 95% CI 4.58-5.21).

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Conclusion · 1 of 2

Lower neighborhood socioeconomic status is independently associated with higher likelihood of urgent colorectal cancer presentation, postoperative complications, and early mortality.

Conclusion · 2 of 2

Incorporating neighborhood socioeconomic context into colorectal cancer care delivery, risk adjustment, and equity-focused policy frameworks may improve outcomes for disadvantaged populations.

Socioeconomic Gradients Measured by the Yost Index and Colorectal Cancer Outcomes: A SEER-Medicare Analysis.

Socioeconomic Gradients Measured by the Yost Index and Colorectal Cancer Outcomes: A SEER-Medicare Analysis.

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