社会脆弱性与甲状腺癌差异的关联 在美国
David Jun Fei-Zhang1, Rhea Verma1, Ryuji Arimoto2
1Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Thyroid : official journal of the American Thyroid Association
|December 9, 2023
概括
越来越多的社会脆弱性会对甲状腺癌的治疗产生负面影响,导致随访,生存和治疗减少. 关键因素包括社会经济地位,语言和住房,突出显示了美国的巨大差异.
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:
- 甲状腺癌的发病率正在上升,需要认识到治疗和诊断的差异.
- 以前对甲状腺癌健康的社会决定因素 (SDoH) 的研究是有限的,主要关注单个因素或儿科患者群体.
- 需要评估SDoH对美国甲状腺癌护理的综合影响.
研究的目的:
- 评估各种SDoH对美国甲状腺癌差异的综合,现实世界的影响.
- 量化SDoH对成人甲状腺癌患者的随访,生存,分期和治疗接收的影响.
- 确定导致这些差异的特定SDoH变量.
主要方法:
- 对199,340名成年甲状腺癌患者 (1975-2017) 的回顾性队列研究,使用CDC社会脆弱性指数和SEER患者数据库.
- 在甲状腺癌亚型中对随访,生存,分期和治疗接收的回归趋势的分析.
- 评估美国各县的15个SDoH变量 (社会经济地位,语言,家庭组成,住房运输),考虑区域社会人口统计差异.
主要成果:
- 增加的社会脆弱性与所有甲状腺癌亚型的随访时间减少相关 (p=0.001).
- 随着脆弱性增加,生存率显著下降,特别是在形和细胞性甲状腺癌中.
- 更高的脆弱性与乳头甲状腺癌晚期发展的几率增加以及接受指示治疗 (手术,放射,化疗) 的几率降低有关.
- 社会经济地位,少数民族语言地位和住房运输脆弱性是观察到的差异的关键因素.
结论:
- 越来越多的社会脆弱性在美国显著恶化了甲状腺癌的治疗和预后.
- 具体的SDoH,包括社会经济地位,语言和住房,显然有助于这些差异.
- 研究结果强调需要有针对性的干预措施来解决SDoH,并减少甲状腺癌护理不平等.
相关概念视频
01:23The 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
01:20Synthesis and Regulation of Thyroid Hormones
4.6K
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...
4.6K
01:18Functions of Thyroid Hormones
2.8K
The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
2.8K
01:19Psychoneuroimmunology: Diabetes and Cancer
29
Chronic stress has been linked to both the onset and progression of serious health conditions, including Type 2 diabetes and cancer. Type 2 diabetes, a widespread chronic illness, is closely associated with obesity and insulin resistance, both of which often worsen under stress. Studies indicate that men experiencing high levels of chronic stress face a 45% higher risk of developing diabetes compared to those with minimal stress. Stress triggers physiological responses that elevate blood...
29
01:18Factors Affecting Illness
4.2K
When a person's physical, emotional, intellectual, social development or spiritual functioning is compromised, this deviation from a healthy normal state is called illness. Illness creates stress that in turn harms individuals. Irritation, anger, denial, hopelessness, and fear are behavioral and emotional changes an individual experiences in the phases of illness. A variety of factors influence a person's health and well-being.
For instance, risk factors are connected to illness,...
For instance, risk factors are connected to illness,...
4.2K
02:59Cancer Prevention
6.2K
Several factors can increase the risk of cancer in an individual. About 50% of cancer cases can be prevented by adopting a healthy lifestyle, regular exercise, eating healthy, and following a modest cancer prevention diet. Epidemiological studies have consistently shown that populations with vegetable and fruit-rich diets have reduced the incidence of cancer. On the other hand, populations who have a diet rich in animal fat, red meat, junk food, or high calories are predisposed to cancer.
Some...
Some...
6.2K