在非小细胞肺癌的分期,治疗和死亡率方面存在种族差异
Francesca C Duncan1, Nawar Al Nasrallah1, Lauren Nephew2
1Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
Translational lung cancer research
|February 26, 2024
概括
健康的社会决定因素,而不仅仅是种族,显著影响非小细胞肺癌 (NSCLC) 诊断阶段和生存率. 解决社会经济因素对于公平的NSCLC护理至关重要.
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:
- 黑人种族与先进的非小细胞肺癌 (NSCLC) 诊断和更高的死亡率有关.
- 在研究NSCLC的种族差异时,现有的研究往往忽视了健康的社会决定因素 (SDOH).
- 本研究调查了SDOH在NSCLC诊断阶段,治疗和结果中的作用.
研究的目的:
- 探索SDOH影响NSCLC诊断阶段和患者结果的种族差异的假设.
- 检查SDOH如何影响患者和医疗保健提供者做出的治疗决定.
- 确定与先进诊断,延迟治疗和NSCLC患者的生存相关的特定SDOH.
主要方法:
- 在印第安纳大学西蒙综合癌症中心2000-2015年间诊断的3,349名NSCLC患者的回顾性研究.
- 使用多变量回归分析来评估SDOH (种族,性别,保险,婚姻状况) 对诊断阶段,治疗时间和接受指导方针一致的护理的影响.
- 卡普兰-梅尔曲线被用来分析5年整体存活率 (OS).
主要成果:
- 晚期NSCLC在男性,无保险和黑人患者中更为常见.
- 在黑人患者,男性,单身患者,无保险者和有医疗保险/医疗补助的人群中观察到较低的5年生存率.
- 黑人,单身,寡妇和没有保险的人不太可能接受高级NSCLC的相应阶段治疗.
结论:
- 在NSCLC诊断,治疗和生存方面存在种族,性别和社会经济差异.
- 保险类型和婚姻状况,而不是仅仅种族,与更糟糕的整体存活率有关.
- 种族结果差异可能源于黑人个体中不成比例地更糟糕的SDOH,需要针对性干预以提供公平的NSCLC护理.
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