前列腺癌男性治疗设施的旅行时间和死亡率
Stephan M Korn1,2,3, Filippo Dagnino1,2,4,5, Danesha Daniels1,2
1Department of Urology Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
JAMA network open
|December 3, 2025
概括
较长的前往前列腺癌治疗设施的旅行时间与较低的死亡率有关. 这表明集中护理可能会改善结果,但需要考虑进入障碍.
科学领域:
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
- 在瘤学瘤学.
背景情况:
- 对前列腺癌护理的地理位置影响患者的治疗结果.
- 传统的措施,如直线距离,可能不反映实际的旅行负担.
- 了解旅行时间的作用对于公平的癌症护理至关重要.
研究的目的:
- 评估前列腺癌患者预计到达治疗设施的旅行时间与死亡率之间的关联.
- 调查旅行时间是否影响全因和前列腺癌特定死亡率.
主要方法:
- 使用来自全国代表性癌症注册表的数据进行回顾性队列研究.
- 包括2000年至2015年间在美国多个州被诊断患有前列腺癌的159,943名男性.
- 使用地理编码和道路网络数据估计的旅行时间;使用Cox回归分析死亡率.
主要成果:
- 旅行时间较长的患者 (≥30分钟) 在统计学上显著地降低了全因死亡率的风险 (aHR,0.91;95% CI,0.89-0.93).
- 较长的旅行时间也与较低的前列腺癌特异性死亡率风险有关 (aHR,0.90;95% CI,0.86-0.95).
- 这些关联在分析的大多数子组中保持一致.
结论:
- 长时间前往前列腺癌治疗设施的旅行时间与死亡率降低有关.
- 这可能表明在专门中心集中护理的好处.
- 研究结果强调需要解决交通等通道障碍,以防止诊断延迟.
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