城市和农村退伍军人的结直肠癌特征和死亡率
Minh Anh Le1, Po-Hong Liu2, Amar Mandalia3
1University of Central Florida, Orlando.
概括
患有结直肠癌的农村和城市退伍军人存活率相似. 退伍军人卫生管理局 (VHA) 的综合系统可以减少生活在农村地区的退伍军人的癌症护理差异.
科学领域:
- 癌症学
- 公共卫生
- 医疗服务研究
背景情况:
- 结肠直肠癌 (CRC) 是美国癌症死亡的主要原因.
- 农村人口在CRC查和管理方面面临着独特的挑战.
- 在退伍军人卫生管理局 (VHA) 中,农村和城市退伍军人之间的CRC护理差异尚不清楚.
研究的目的:
- 检查诊断为CRC的退伍军人的特征和死亡率.
- 将农村和城市退伍军人的生存结果与CRC进行比较.
- 在VHA内调查CRC护理的潜在差异.
主要方法:
- 使用了2016-2021财年的VHA数据,用于新诊断的CRC退伍军人.
- 使用农村城市通勤区 (RUCA) 分类为城市或农村的地区.
- 使用倾向性比分分析来比较农村和城市CRC患者的基线特征和死亡率.
- 在45岁或更年轻的退伍军人中进行二次CRC分析.
主要成果:
- 这项研究包括19422名城市和10797名农村退伍军人.
- 农村CRC患者更有可能是白人,年长,肥胖,但并发病率较低.
- 在倾向分数匹配后,农村 (34. 9%) 和城市 (34. 3%) 退伍军人CRC的总死亡率相似 (HR,1. 01;95% CI,0. 97-1. 06).
- 农村和城市地区的年轻退伍军人 (≤45岁) 的死亡率也相似 (HR,0.97;95% CI,0.57-1.63).
结论:
- 在VHA的农村和城市环境中患有结直肠癌的退伍军人经历了相似的生存结果.
- 这些研究结果表明,像VHA这样的综合医疗系统可以有效地减轻癌症治疗的城乡差异.
- 进一步的研究可以探索有助于公平CRC结果的特定VHA策略.
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