Abstract: Objective To explore the relationship between socioeconomic status (SES) and disease mortality in patients with cecal adenocarcinoma in America through the Surveillance, Epidemiology, and End Results (SEER) database. Methods The SEER database was queried for patients with cecal adenocarcinoma in America diagnosed from 2011 to 2015. Factor analysis, cluster analysis, and univariate and multivariate Cox proportional hazard models were used for data analysis. Five social security factors were identified: factor 1, economic and educational disadvantage; factor 2, characteristics related to immigration (language isolation and foreign birth); factor 3, high relocation rate in the county; factor 4, high intra-state relocation rate; and factor 5, high domestic relocation rate. Five clusters defined by SES were identified. Results The number of all-cause deaths among 17 185 patients was 5948, and the number of survivors was 11,237. In the multivariate Cox regression analysis, with cluster 1 (low poverty rate and high education level) as the reference, the hazard ratio (HR) of cluster 3 (high intra-county mobility rate) was 1.13 (95% CI: 1.04-1.21, P<0.05), and the risk was 13% higher than that of cluster 1. The HR of cluster 4 (low language isolation, foreign birth, housing overcrowding, and intra-country mobility rates) was 1.15 (95% CI: 1.07-1.24, P<0.001) with a 15% higher risk than cluster 1. The HR of cluster 5 (economic and educational disadvantages, immigration-related characteristics, and low intra-country mobility) was 1.11 (95% CI: 1.03-1.20, P<0.01) with a 11% higher risk. The factors related to SES indicators were based on the mortality of patients with cecal adenocarcinoma, indicating that low economic and education levels are risk factors for cecal adenocarcinoma. Conclusion Low socioeconomic status is associated with an increased risk of death in patients with cecal adenocarcinoma in the United States and show different distribution patterns based on population. Improving health insurance policies and strengthening psychotherapy can provide guidance for improving prognosis f cecal adenocarcinoma patients.

Key words: SEER; socioeconomic status; cecal adenocarcinoma; survival rate