利用农村-城市通勤区工具解决癌症护理的地理差异:机构和国家倡议的双重应用框架
Meredith C B Adams1, Cody L Hudson1, Matthew L Perkins1
1Wake Forest University School of Medicine, Winston-Salem, NC.
JCO clinical cancer informatics
|November 7, 2025
概括
一个新的农村-城市通勤区 (RUCA) 工具为癌症研究提供了精确的地理编码,改进了传统的县级措施. 这增强了癌症差异研究,并支持针对农村人口的有针对性的干预措施.
科学领域:
- 公共卫生 公共卫生
- 地理信息系统 (GIS) 是指地理信息系统.
- 癌症流行病学 癌症流行病学
背景情况:
- 癌症差异研究需要准确的地理数据来识别和解决健康不平等问题.
- 现有的县级分类可能缺乏捕捉农村-城市分界的细微差别所需的细节性.
- 标准化对于满足数据要求至关重要,例如来自国家卫生研究院 (NIH) 帮助结束成长期 (HEAL) 倡议的数据要求.
研究的目的:
- 开发和验证一个开放的农村城市通勤区 (RUCA) 工具,用于癌症差异研究中的标准化地理编码.
- 为了满足NIH HEAL倡议的共同数据元素要求,并支持机构的流域区域分析.
- 为改善地理分类提供人口普查区级精度.
主要方法:
- 开发了一个基于网络的工具,集成美国农业部的RUCA代码,人口普查数据和电子健康记录.
- 使用2023年韦克森林癌症中心的注册数据 (n=21,219) 实现了该工具.
- 进行了与县级农村城市连续代码 (RUCC) 分类的系统比较,使用336个邮政编码的18,714例癌症病例来对乳腺,结肠和肺癌进行比较.
主要成果:
- 19.51% (n=4,140) 的癌症患者居住在农村地区,其中4.81% (n=1,022) 居住在最农村的人口普查区 (RUCA代码7-10).
- 在RUCA和RUCC分类之间观察到9.4%的差异,影响了1,765名患者.
- 由RUCA分类为农村的28个邮政编码位于RUCC的大都市县内,错误分类了109名癌症患者.
结论:
- 该RUCA工具提供了必要的普查通道级精度,克服了癌症研究中县级分类的局限性.
- 这种双重应用的框架使机构分析与国家标准化工作保持一致.
- 该工具确定了109名通过传统方法错误分类的患者,从而为农村癌症护理提供了更好的针对性干预措施.
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