儿童甲状腺癌:社会经济差异及其对获得护理的影响
Heming H Zhao1, Scott M Wilhelm1
1University Hospitals, Cleveland Medical Center, Cleveland, OH.
Surgery
|October 20, 2023
概括
在小儿甲状腺癌护理获取和结果方面存在差异. 社会经济因素和种族对差异化甲状腺癌患者的治疗延迟和生存有重大影响.
科学领域:
- 儿科瘤学 儿科瘤学
- 医疗保健服务研究 医疗服务研究
- 癌症的差异 在癌症的差异中
背景情况:
- 关于儿童甲状腺癌的医疗保健准入差异的研究有限.
- 了解影响儿科差异化甲状腺癌 (DTC) 和侵袭性乳头甲状腺癌 (PTC) 变种治疗的社会经济和患者因素至关重要.
研究的目的:
- 调查影响儿童差异化甲状腺癌和侵袭性乳头甲状腺癌变体获得护理的社会经济和患者相关因素.
- 识别随着时间的推移获得护理和结果的趋势.
- 分析在治疗和生存方面的种族/民族和社会经济差异.
主要方法:
- 国家癌症数据库 (2004-2019) 对儿科DTC和侵袭性PTC的回顾性分析.
- 患者被分为三个时间段 (2004-2008,2009-2013,2014-2019) 来评估时间趋势.
- 统计分析 (奇平方,克鲁斯卡尔-瓦利斯) 用于评估社会经济和疾病因素.
主要成果:
- 分析包括6,275名儿科DTC患者和182名具有侵略性的PTC.
- 医疗补助和低收入的DTC患者面临更长的旅程距离护理 (2014-2019).
- 观察到的种族/种族差异:黑人和西班牙裔患者延迟手术 (>30天) 的几率更高. 与白人和西班牙裔患者相比,黑人DTC患者的死亡风险增加. 在西班牙裔DTC患者中,节点阳性性更高.
- 社会经济因素没有显著影响侵略性PTC变体的存活率或节点阳性.
结论:
- 对于儿科DTC和积极的PTC,在获得护理和生存结果方面存在显著的差异.
- 种族,收入和保险类型是这些差异的关键决定因素.
- 进一步的研究和有针对性的干预措施是必要的,以改善护理准入和患者的结果.
更多相关视频
相关概念视频
The Thyroid Gland
3.9K
The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
3.9K
Synthesis and Regulation of Thyroid Hormones
4.7K
Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
4.7K
Cancer Therapies
7.7K
Cancer therapies are various modes of treatment, such as surgery, radiation therapy, and chemotherapy that are administered to cancer patients.
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
7.7K
Issues And Trends In Healthcare Delivery System
5.6K
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
5.6K
Targeted Cancer Therapies
7.7K
The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against...
There are several types of targeted therapies against...
7.7K
Treatment Resistant Cancers
3.3K
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
3.3K


