估计农村生活对癌症死亡率差异的影响
Kelly M Kenzik1,2, Elizabeth S Davis1, Jeffrey A Franks3
1Department of Surgery, Boston University, Boston, MA.
JCO oncology practice
|April 1, 2024
概括
农村独立生活增加了癌症死亡风险,特别是在贫困地区的局部疾病. 农村-城市名称可能会错误地分类城市县,影响资源分配.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 癌症研究 癌症研究
背景情况:
- 城市和农村人口之间的癌症死亡率差异是一个重大的公共卫生问题.
- 了解农村对癌症结果的独立贡献对于有针对性的干预措施至关重要.
研究的目的:
- 用因果推理估计农村居住对癌症死亡率的独立影响.
- 通过使用区域贫困指数 (ADI) 评估区域级社会经济地位对农村癌症死亡率的影响.
- 检查农村-城市县的指定如何影响死亡率和资源分配.
主要方法:
- 利用监测,流行病学和最终结果 (SEER) 数据,用于2000-2016年间诊断的发生癌症.
- 采用标准化竞争风险和生存模型来分析农村居住 (农村-城市连续代码) 和死亡率之间的关联.
- 对人口因素,诊断年和ADI进行控制;为农村和高ADI计算可归因分数 (AF).
主要成果:
- 与城市 (31.56%) 相比,农村居住与更高的5年癌症死亡概率 (33.9%) 相关.
- 农村居民的可归因分数在第1年为1.04%和第5年为0.89%,对于局部疾病来说最高.
- 高ADI为死亡率贡献了3.33% (Y1),农村和高ADI的联合效应为4.28% (Y1).
结论:
- 农村居住是癌症死亡率的独立风险因素,特别是在局部疾病和贫困地区.
- 农村-城市县分类可能不准确地分类高需求的城市地区,可能会阻碍获得基本资源的机会.
- 解决农村癌症差异需要细微的理解,而不仅仅是简单的地理指定.
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