与拒绝乳腺癌手术相关的县特征:来自监测,流行病学和最终结果计划的证据
Oindrila Bhattacharyya1, Theresa Relation2, James L Fisher3
1James Comprehensive Cancer Center, The Ohio State University, Columbus, OH; The William Tierney Center for Health Services Research, Regenstrief Institute, Inc, Indianapolis, IN.
Surgery
|June 9, 2023
概括
社区的社会经济因素对种族和民族少数群体的乳腺癌手术拒绝率有很大影响. 较低社会经济地位的县与更高的拒绝率有关,增加癌症死亡率.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 健康差异 在健康上的差异
背景情况:
- 社区社会经济因素对癌症差异产生重大影响,并与健康的社会决定因素有关.
- 虽然研究了影响癌症治疗拒绝的个人因素,但对手术接收的社区层面影响仍未得到充分研究.
研究的目的:
- 调查社区层面的因素与被诊断为非转移性乳腺癌的妇女的手术拒绝率之间的关联.
- 为了检查非西班牙裔白人,非西班牙裔黑人和西班牙裔妇女的手术拒绝差异.
主要方法:
- 利用了2010-2015年监测流行病学和最终结果 (SEER) 计划数据.
- 分析了与乳腺癌手术拒绝有关的县级社会人口统计和社区因素.
- 采用多变量逻辑回归和Cox比例危险模型来评估预测因素和死亡率.
主要成果:
- 拒绝手术的情况在受教育程度,收入较低,贫困率和失业率较高的县里更高.
- 多变量分析表明,城市县的手术拒绝率增加,高等教育和收入的拒绝率下降.
- 乳腺癌特异性死亡率在拒绝手术的女性中显著更高.
结论:
- 居住在社会经济地位较低的县,特别是那些有大量少数民族人口的县,与更高的乳腺癌手术拒绝率有关.
- 建议采取文化敏感的教育干预措施,以应对风险社区中与拒绝手术相关的高死亡率.
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