在前列腺癌复发的农村和城市差异
Julia B Balmaceda1, Aaron J Katz2,3, Ying Cao2
1Department of Internal Medicine, University of Kansas Medical Center, Kansas City.
JAMA network open
|August 8, 2025
概括
与城市同行相比,农村前列腺癌患者的复发率更高. 这种差异可能源于社会经济因素和获得护理的机会,强调需要进一步调查农村癌症的结果.
科学领域:
- 在瘤学瘤学.
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 农村患者在获得高质量的癌症护理方面面临着独特的挑战.
- 现有的研究还没有充分确定这些差异是否导致临床结果较差.
研究的目的:
- 调查农村和城市男性之间前列腺癌生化复发率的差异.
- 根据地理居住地确定前列腺癌结局的潜在差异.
主要方法:
- 在北卡罗来纳州 (2011-2013) 新诊断的前列腺癌患者的基于人口的队列研究.
- 用农村-城市连续代码将患者分为农村或城市.
- 生物化学复发通过前列腺特异性抗原测试来评估,使用Cox比例危险模型进行分析.
主要成果:
- 在多变量调整后,农村居住与更高的生化复发率 (HR,1.74;P = .03) 有关.
- 放射治疗显示出与复发的反向关联 (HR,0.51;P = .01).
- 诸如NCCN风险组和先前活检等因素也影响了复发率.
结论:
- 患有前列腺癌的农村患者表现出更高的生化复发率.
- 根本原因可能是多因素的,可能涉及社会经济地位,护理延迟和获得多学科护理.
- 需要进一步的研究来解决这些差异,并改善农村癌症患者的治疗结果.
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