离治疗设施更远的距离与呈现时的晚期结肠癌和增加死亡率有关
Ryan K Schmocker1, Laura M Enomoto1, Gregory K Low2
1Division of Surgical Oncology, University of Tennessee Medical Center, Knoxville, TN, USA.
The American surgeon
|March 29, 2024
概括
与治疗设施的距离增加与晚期结肠癌阶段和较高的死亡率有关,特别是影响农村患者. 这凸显了癌症护理获取的差异以及有针对性的干预措施的必要性.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在美国,结肠癌的发病率有所改善,但显著的差异仍然存在,特别是在农村地区.
- 距离治疗设施对结肠癌死亡率和结果的独立影响尚不清楚.
- 这项研究调查了结肠癌患者的设施距离,诊断阶段和死亡率之间的关系.
研究的目的:
- 评估与治疗设施的距离是否独立影响结肠癌在诊断和死亡时的阶段.
- 为了确定与地理位置相关的结肠癌护理获取的潜在差异.
主要方法:
- 利用国家癌症数据库 (NCDB) 对一组成年结肠癌患者 (2013-2017) 进行了分析.
- 测量结果包括结肠癌TNM阶段,手术时间,化疗时间和整体存活率.
- 对患者因素进行控制:种族,教育,保险,并发症和收入.
主要成果:
- 治疗设施的距离增加显著预测了在呈现时更先进的临床TNM阶段 (AORs 1.12-1.62,P <.001).
- 较长的距离与手术延长时间 (5.06-14.46天,P < .001) 和较高的整体死亡率相关 (HR 1.11-1.28,P < .001).
- 对于离治疗设施更远的患者 (75.1个月 vs 82.4个月,P < .001),中位生存时间明显较低.
结论:
- 较远的治疗设施与诊断时较高的结肠癌阶段,延迟的手术和增加的死亡率有关.
- 调查结果显示,农村人口在获得癌症护理方面的差异很大.
- 针对性干预对于改善乡村结肠癌患者的查和及时治疗至关重要.
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