针对晚期癌和膀癌的免疫治疗利用的社会经济和人口差异
Levi Holland1, Raj Bhanvadia1, Nathanaelle Ibeziako1
1Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
Urologic oncology
|July 21, 2024
概括
免疫疗法 (IO) 对于晚期脏和膀癌的使用正在增加,但接入差异仍然存在. 收入,教育和保险等社会经济因素显著影响IO收款,与癌中的种族一起.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 生殖尿道癌症 生殖尿道癌症
背景情况:
- 免疫疗法 (IO) 对晚期清晰细胞细胞癌 (ccRCC) 和膀 (UC) 尿路细胞癌 (UC) 提供了生存益处.
- 获得这些先进疗法可能受到各种因素的限制,类似于其他癌症类型.
- 了解社会经济和人口统计学对IO接收的影响对于公平护理至关重要.
研究的目的:
- 研究社会经济,人口因素与在晚期ccRCC和UC患者中使用免疫疗法 (IO) 之间的关联.
- 为了识别这些生殖尿道恶性瘤的IO治疗机会的差异.
主要方法:
- 分析国家癌症数据库 (NCDB) 对被诊断为IV期ccRCC (2015-2020) 和UC (2017-2020) 的患者的分析.
- 使用多变量逻辑回归来确定主要结果:接受IO治疗.
- 调整主要的社会经济和人口变量,包括教育,收入,保险和治疗设施类型.
主要成果:
- 对于ccRCC和UC,IO利用量每年都在增加.
- 在非学术设施的治疗,较低的教育,较低的收入和缺乏保险独立地与两种癌症类型的IO接收减少有关.
- 对于ccRCC,黑人和西班牙裔种族也与明显较低的IO利用率有关,但这在UC中没有观察到.
结论:
- 尽管对先进的ccRCC和UC的IO利用率不断增加,但与社会经济地位和保险相关的显著差异仍然存在.
- 在非学术中心和少数种族群体 (特别是ccRCC) 接受治疗的患者面临减少IO治疗的机会.
- 迫切需要采取战略来解决这些不平等问题,并确保所有患有晚期生殖尿路癌症的患者均可获得免疫治疗.
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