分析美国头部和部黑色素瘤的县级社会脆弱性
Lillian McCampbell1, David Jun Fei-Zhang2, Daniel Chelius3
1Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A.
The Laryngoscope
|June 21, 2023
概括
更高的社会脆弱性与较差的头黑色素瘤 (HNM) 预后和减少后续护理有关. 健康的特定社会决定因素显著影响HNM结果.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 社会流行病学 社会流行病学
背景情况:
- 健康的社会决定因素 (SDH) 影响癌症发病率和结果.
- 关于SDH对头黑色素瘤 (HNM) 的综合影响的研究有限.
- 之前的研究集中在社会经济地位和HNM发病率上,忽视了预后和后续护理.
研究的目的:
- 调查广泛的SDH和HNM预后和随访护理之间的关联.
- 评估社会脆弱性对HNM患者结果的累积影响.
- 确定特定的SDH,有助于在HNM护理和生存方面的差异.
主要方法:
- 来自NCI-监测,流行病学和最终结果 (SEER) 计划的374,138个HNM病例 (1975-2017) 的回顾性队列研究.
- 社会脆弱性指数 (SVI) 的得分与患者在诊断时的居住县相匹配.
- 单变线性回归分析了随访护理持续时间和生存预后,与各种SDH和复合SVI得分相比.
主要成果:
- 增加SVI得分与随访护理 (0.04%27.63%) 和生存预后 (0.19%39.84%) 的显著下降相关.
- 在随访中,结节性黑色素瘤的差异最高;在上皮细胞黑色素瘤的生存率差异最高.
- 结果的下降与社会经济地位,少数民族/语言地位,家庭组成和住房/运输有关,因HNM组织学而异.
结论:
- 较高的社会脆弱性与较差的HNM预后和减少的后续护理有显著的关联.
- 具体的SDH主题,包括社会经济地位和住房/交通,对这些负面结果有不同的贡献.
- 本研究量化了社会脆弱性对HNM护理和生存的影响,突出了针对性干预的领域.
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