184 Unequal Burdens: The Role of Social Deprivation in Presentation, Management and Outcomes of Oesophageal and Gastric Cancer

Abstract Aim To investigate the impact of socioeconomic deprivation on the presentation, treatment, and outcomes of patients diagnosed with upper gastrointestinal cancer. Method An analysis was conducted using a prospectively maintained cancer database at Trinity St. James’s Cancer Institute, identifying 3,220 patients diagnosed between 2014 and 2024. Each patient’s residential address was geocoded to obtain the corresponding Eircode, and patients were stratified by national deprivation quintiles based on their postcodes. Data were analysed using SPSS, evaluating key variables including lifestyle factors (smoking status, alcohol consumption), ASA grade, comorbidities, and postoperative outcomes. Results Patients from lower socioeconomic groups had a higher prevalence of modifiable risk factors, including current smoking and heavy alcohol consumption. They also presented with more advanced ASA grades and increased rates of abnormal preoperative investigations (PFTs, echocardiograms). Postoperative complications were more frequent in this group. However, metastasis and recurrence rates were comparable across all socioeconomic strata. Conclusions Patients from socioeconomically deprived backgrounds exhibit poorer preoperative health profiles and experience higher rates of postoperative complications, despite similar tumour progression patterns. These findings suggest that disparities beyond tumour biology influence outcomes. Future longitudinal studies stratified by deprivation status are warranted to further explore the long-term effects of socioeconomic inequality on cancer survival.