伴随性疾病,社会经济地位和结直肠癌诊断路线
Flavia Pennisi1,2,3, Carlotta Buzzoni3, Antonio Giampiero Russo3
1School of Medicine, University Vita-Salute San Raffaele, Milan, Italy.
JAMA network open
|May 6, 2025
概括
患有三种或以上并发症的结肠直肠癌 (CRC) 患者不太可能通过查进行诊断,并且更有可能获得紧急癌症诊断. 这凸显了针对性干预的必要性,以改善慢性病患者的CRC结果.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 减少紧急癌症诊断对于改善患者的治疗结果至关重要.
- 以前存在的慢性疾病可能会影响癌症查参与和诊断途径,但证据有限,特别是在南欧.
研究的目的:
- 分析共患病状况和社会经济因素如何影响结肠直肠癌 (CRC) 诊断途径 (查与紧急呈现).
- 调查患者特征,诊断途径和与CRC相关的短期死亡率之间的关联.
主要方法:
- 一项以人口为基础的队列研究利用了意大利 (2014-2020年) 的链接癌症注册表和行政健康数据.
- 分析包括14457例CRC病例,检查并发症状况,社会经济因素,诊断途径和短期死亡率,使用多变量逻辑回归.
主要成果:
- 超过三分之一的结肠癌病例是通过紧急呈现诊断的.
- 患有三种或更多并发症的患者查检测的几率较低,紧急诊断的几率更高.
- 紧急呈现与明显更高的30天和1年死亡率有关. 在COVID-19期间,紧急诊断的数量增加.
结论:
- 患有多种并发症的患者面临查障碍,更容易被紧急诊断为癌症.
- 量身定制的干预措施对于加强查参与和减少脆弱人群的紧急诊断至关重要.
- 改善慢性病患者的诊断途径可以导致更好的CRC结果.
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