112,000名患有癌症的青少年和年轻人的社会脆弱性和生存率:基于人口的研究
Guillermo A Tortolero1, Andrea C Betts2, Tiffany A Suragh2
1Department of Epidemiology, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA.
Journal of the National Cancer Institute
|July 31, 2024
概括
社区的社会脆弱性对青少年和年轻人 (AYA) 的癌症存活率产生重大影响. 更高的脆弱性与生存率的下降有关,这突显了针对性干预措施解决健康差异的必要性.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 社会流行病学 社会流行病学
背景情况:
- 邻居因素影响癌症的结果,但研究往往忽略了青少年和年轻人.
- 社会脆弱性,包括各种社会经济风险,是健康差异的关键关注领域.
研究的目的:
- 调查社区层面的社会脆弱性与青少年和年轻人 (AYA) 癌症存活率之间的关联.
- 量化社会脆弱性对被诊断患有癌症的AYA全因死亡率的影响.
主要方法:
- 利用来自德克萨斯州癌症登记处的基于人口的数据,包括112,142名AYA (15-39岁).
- 通过对14个人口普查区级社会风险因素的综合测量,评估了社区的社会脆弱性.
- 估计的1,5和10年整体生存率,跨越社会脆弱性的五分之一.
- 采用Cox的比例危险模型来确定社会脆弱性与所有原因死亡率之间的关联.
主要成果:
- 癌症生存率随着社会脆弱程度的增加而逐渐下降.
- 在最脆弱的五分之一 (74.0%) 与最脆弱的五分之一 (86.5%) 相比,五年生存率明显较低.
- 在调整后的模型中,社会脆弱性与全因死亡率的增加显著相关 (最高和最低五分位数的aHR = 1.55).
结论:
- 社区的社会脆弱性是青少年和年轻人的癌症生存的关键决定因素.
- 解决邻里差异对于在AYA中实现公平的癌症结果至关重要.
- 针对健康的社会决定因素的干预措施是必要的,以提高弱势群体的生存率.
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