近所の社会経済的地位と乳がんの発生率と死亡率の関連性:大規模なコホート研究の体系的レビューとメタ解析
Faramarz Jalili1, Mohammad Hajizadeh2, Sanaz Mehrabani3
1School of Health Administration, Faculty of Health, Dalhousie University, Halifax, NS, Canada. FJalili@dal.ca.
Breast cancer (Tokyo, Japan)
|August 30, 2025
まとめ
社会的・経済的状況が不利な地域 (n-SES) は,乳がんによる死亡率の上昇と関連しています. 脆弱な集団の乳がんに 影響を及ぼす社会経済的不平等に対処するために 標的を絞った介入が必要である.
科学分野:
- 腫瘍学
- 公衆衛生
- 社会流行病学
背景:
- 乳がん (BC) は,世界中でがんによる死亡の主な原因です.
- 近所の社会経済的地位 (n-SES) はBC発生率と生存に影響を与えるかもしれないが,結果は矛盾している.
- BCの結果に対するn-SESの影響に関する包括的な理解は欠けている.
研究 の 目的:
- n-SESとBCの発生率と死亡リスクとの関連を体系的に検討し,メタ分析する.
- n-SESとBCの結果に関する不一致を明らかにする.
- 社会経済的な要因に基づいてBCの発生率と死亡率の潜在的格差を特定する.
主な方法:
- Web of Science,PubMed/MEDLINE,およびScopusの体系的な文献検索を行った.
- ランダム効果モデルを用いた17の研究 (779,352人) のメタ分析.
- 品質評価 (ニューカッスル・オタワスケール),サブグループ分析,感度分析,出版バイアステスト (エッガー回帰).
主要な成果:
- 劣勢なn- SESと全体的なBC発生リスクとの間に有意な関連性はない (HR=1. 19).
- サブグループ分析では,症例対照試験とルミナルAサブタイプではBCの発生率が低下したが,HER2+とトリプルネガティブサブタイプでは発生率が上昇した.
- 劣勢なn- SESとより高いBC死亡リスク (HR=1. 32) の間に有意な関連性が見つかりました.
結論:
- 劣ったn-SESは乳がんの死亡率の上昇に寄与する重要な要因です.
- 社会経済的な格差を理解することは 対象を絞った介入の開発に不可欠です
- BCの発生率と死亡率の不平等に対処することで,リスクのある集団のアウトカムを改善できます.
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