智力或发育障碍和女性乳腺癌治愈治疗:基于人口的回顾性队列研究
Rebecca L Hansford1, Brooke Wilson2, Rebecca Griffiths3
1Department of Public Health Sciences, Queen's University, Kingston, ON, Canada; Cancer Care & Epidemiology, Sinclair Cancer Research Institute, Queen's University, Kingston, ON, Canada.
Breast (Edinburgh, Scotland)
|June 16, 2025
概括
智力或发育障碍 (IDD) 的成年人接受的乳腺癌治疗较少,包括手术和化疗. 需要进一步的研究,以改善这一群体的护理准入和结果.
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:
- 与一般人口相比,智力或发育障碍 (IDD) 的成年人面临更高的乳腺癌死亡率.
- 乳腺癌治疗的差异可能导致这些生存率差异.
- 本研究调查了IDD和没有IDD的成年人接受乳腺癌治疗的情况.
研究的目的:
- 为了比较成年人与没有智力或发育障碍 (IDD) 之间接受关键乳腺癌治疗的情况.
- 确定手术切除,化疗和放射治疗中的潜在差异.
- 为改善公平的癌症护理服务提供策略提供信息.
主要方法:
- 一项基于人口的回顾性队列研究,利用加拿大安大略省 (2007-2018) 的行政数据.
- 包括被诊断患有I-III阶段乳腺癌的成年女性,通过已确定的算法确定IDD状态.
- 使用因果特异性危险模型来估计IDD与接受治疗之间的关联,并考虑竞争性风险.
主要成果:
- 患有IDD的个体不太可能接受手术切除 (HR=0.84),乳房保护手术 (HR=0.69),辅助化疗 (HR=0.49) 和放射治疗 (HR=0.58).
- 接受乳房切除术的情况在两组之间是相似的 (HR=1.13).
- 对于乳房切除和乳房保护手术的接收,观察到年龄和IDD之间的显著相互作用.
结论:
- 患有IDD的成年人不太可能接受指南推的乳腺癌治疗,这可能会影响生存结果.
- 进一步的研究对于了解治疗决策和可访问性障碍至关重要.
- 需要有针对性的干预措施,以确保IDD患者平等获得最佳乳腺癌护理.
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