与肝细胞癌发病率和死亡率相关的社区层面因素:一个观察性注册研究
Catherine Mezzacappa1, Raiza Rossi1, Ariel Jaffe1,2
1Yale Liver Center, Section of Digestive Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.
概括
贫困和较低的教育水平等社会经济因素与较高的肝癌 (肝细胞癌 - HCC) 和较差的生存率有关. 识别高风险社区可以帮助准资源来减少这些健康差异.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 健康差距 研究 研究 研究 研究
背景情况:
- 肝细胞癌 (HCC) 的发病率和结果在美国显示出显著的地理差异.
- 导致这些差异的当地社会经济和环境因素尚未得到充分理解.
- 了解社区层面的驱动因素对于有效的资源配置和早期检测策略至关重要.
研究的目的:
- 在社区层面测量HCC发病率.
- 确定与HCC发病率和存活率相关的社区级风险因素.
- 为改善早期HCC检测和减少差异提供资源分配信息.
主要方法:
- 利用康涅狄格州瘤登记 (2008-2019) 的数据来诊断成人HCC.
- 综合美国人口普查和CDC数据在邮政编码表格区域 (ZCTA) 层面.
- 计算每 ZCTA 的 HCC 年均发病率,并评估与社区特征,诊断阶段和生存率的关联.
主要成果:
- 年平均HCC发病率为8.9/100,000成年人,ZCTA水平从0到97.7/100,000变化.
- 较低的高中毕业率,较高的贫困率和农村生活与HCC发病率的增加有关.
- 患有最高发病率的ZCTA的个体被诊断为年轻人,并降低了1年,2年和5年生存率.
结论:
- 社区层面的社会经济因素与康涅狄格州的HCC发病率和生存率有着强烈的关联.
- 一种可重现的地理定位方法可以识别需要卫生系统投资以减轻HCC差异的社区.
- 基于社区级数据的有针对性的干预措施可以改善肝细胞癌的早期检测和结果.
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