持续的邻里贫困和乳腺癌的结果
J C Chen1, Demond Handley2,3, Mohamed I Elsaid2,3,4
1Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus.
JAMA network open
|August 29, 2024
概括
生活在持续贫困社区的乳腺癌妇女面临更糟糕的结果. 这项研究发现,这些人群的死亡风险更高,瘤更具侵略性,突出了癌症护理方面的差异.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 健康的社会经济决定因素
背景情况:
- 与居住在社会经济弱势社区的乳腺癌患者相比,与生活在富裕地区的患者相比,乳腺癌患者经常经历较差的健康结果,包括死亡率增加.
- 社区持续的贫困是与健康差异相关的重要因素.
- 了解社区贫困对乳腺癌的影响对于解决健康不平等至关重要.
研究的目的:
- 调查持续的社区贫困与乳腺瘤特征之间的关联.
- 检查持续的社区贫困和手术治疗决策之间的关系.
- 确定持续的社区贫困对乳腺癌特定和全因死亡率的影响.
主要方法:
- 在2010年至2018年期间被诊断患有I至III期乳腺癌的18岁或以上妇女的回顾性队列分析.
- 来自监测,流行病学和最终结果 (SEER) 计划的数据.
- 持续贫困定义为人口中≥20%生活在贫困线以下的地区,大约30年;分析包括到2020年为止的死亡率跟踪.
主要成果:
- 持续贫困社区的患者更有可能是黑人或西班牙裔,并且具有更具侵略性的瘤特征 (更高等级,三阴性,晚期).
- 在这些地区,更高比例的患者接受了乳房切除和带淋巴结剖析.
- 居住在持续贫困的社区与乳腺癌特异性 (AHR,1.10) 和全因死亡率 (AHR,1.13) 的风险明显增加有关,风险在诊断后3年就会出现分歧.
结论:
- 持续的邻里贫困与不利的乳腺瘤特征,特定的手术管理模式和乳腺癌患者死亡率增加有关.
- 这些发现强调了与乳腺癌护理中的社会经济劣势相关的重大健康差异.
- 解决住宅区的社会经济因素对于改善乳腺癌结果和降低死亡率至关重要.
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