社区的富裕是否提高了结肠直肠癌的生存率?
Barbara Nemesure1, Linda K Mermelstein2, Kathleen H Scarbrough1
1Department of Family, Population and Preventive Medicine, Stony Brook Medicine, Stony Brook, New York.
AJPM focus
|November 9, 2023
概括
在一个富裕的郊区,结肠直肠癌的生存率并不超过全国平均水平. 晚期和老年,而不是社区的繁荣,显著影响了死亡率,突出了早期检测工作的必要性.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 健康的社会经济决定因素
背景情况:
- 大肠直肠癌 (CRC) 是美国癌症死亡的主要原因.
- 较低的社会经济地位 (SES) 和缺乏医疗保险与较低的CRC存活率有关.
- 这项研究调查了富裕的郊区人口中CRC存活率.
研究的目的:
- 为了评估居住在富裕郊区的患者的结肠直肠癌生存率.
- 确定影响该人口死亡率的因素.
- 评估社区繁荣对CRC成果的影响.
主要方法:
- 利用了来自斯托尼布鲁克癌症中心注册表 (2010-2020) 的数据.
- 使用困难社区指数 (DCI) 作为SES的代理,与患者邮政编码联系在一起.
- 统计分析包括奇平方测试,卡普兰-梅尔曲线和危险比率.
主要成果:
- 超过一半的946名CRC患者生活在繁荣的邮政编码 (DCI ≤20).
- 黑人种族和医疗补助保险与非繁荣地区有关.
- 五年生存率为59.2%;晚期和老年 (≥70) 显著增加死亡率 (HR=12.24和HR=2.43分别).
- 没有发现DCI状态与阶段或整体存活率之间的关联.
结论:
- 与全国平均水平相比,富裕的郊区CRC患者的生存率没有提高.
- 诊断时的晚期阶段和年龄较大是死亡率的关键预测因素.
- 增加查教育和减少进入障碍对于改善CRC结果至关重要,无论社区的繁荣程度如何.
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