在前列腺癌临床试验机会的可用性方面存在结构性不平等
Rishi Robert Sekar1,2,3, Laura Zebib4, Kristian Donald Stensland1,2
1Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.
Journal of the National Cancer Institute
|March 4, 2025
概括
前列腺癌临床试验的机会是不平等的. 更高的社会脆弱性与更多的死亡和更少的试验机会有关,突显了在癌症护理中改善公平的需要.
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:
- 前列腺癌不成比例地影响少数群体和社会经济弱势群体,导致临床结果的显著差异.
- 地理和社会经济因素影响了获得重要的癌症临床试验和治疗的机会.
- 健康的社会决定因素 (SVI) 是社区层面脆弱性的关键指标.
研究的目的:
- 分析前列腺癌临床试验机会的地理分布.
- 检查前列腺癌死亡率,社会脆弱性和临床试验准入之间的关系.
- 确定需要有针对性的干预措施的领域,以改善临床试验公平.
主要方法:
- 美国连接的县级数据的生态分析.
- 包括前列腺癌临床试验数据,流行病学数据和CDC社会脆弱性指数 (SVI).
- 统计分析以评估SVI,前列腺癌死亡率和试验可用性之间的关联.
主要成果:
- 增加SVI显著与更高的前列腺癌死亡率有关.
- 较高的SVI与拥有任何前列腺癌临床试验的几率相对较低.
- 较为社会脆弱的县有较少的人口调整的临床试验机会.
结论:
- 在社会上脆弱的社区面临着严重的障碍,无法进入前列腺癌临床试验.
- 解决健康的社会决定因素对于改善癌症临床试验中的公平至关重要.
- 在服务不足的地区扩大试验准入的有针对性的策略可以减轻癌症护理方面的差异.
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