结肠癌患者生活在持续贫困的社区的结果
Leon Naar1, Alexa L Pohl1, Arden M Morris1,2
1Section of Colon & Rectal Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California.
JAMA network open
|January 9, 2026
概括
生活在持续贫困 (PP) 的结肠癌患者面临更高的死亡风险. 符合指导方针的护理可以调解这种联系,突出政策干预的领域.
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:
- 持续的贫困 (PP) 与较差的癌症结局有关.
- 现有的干预措施可能无法解决PP的独特机制.
- 确定可修改的目标对于政策制定至关重要.
研究的目的:
- 根据诊断时PP中人口普查区域的比例,比较结肠癌的临床结果.
- 探索潜在的机制,包括护理的获取和质量,将PP与特定疾病死亡率联系起来.
主要方法:
- 在加利福尼亚州 (2017-2020年) 的20015名结肠癌患者进行了回顾性队列研究.
- 暴露量定义为PP中每个邮政编码的人口普查区的比例.
- 用于评估死亡率和通过护理获取/质量调解的Fine-Gray竞争风险生存模型.
主要成果:
- 较高的PP比率与疾病特异性死亡率的增加有关 (HRs 1.20-1.19).
- 在较高PP区域的患者更年轻,更常见的西班牙裔或黑人,并具有较高的并发症.
- 接受符合指导方针的护理可能会调解PP与死亡率之间的关联.
结论:
- 生活在持续的贫困中与较高的结肠癌死亡率有关.
- 调查结果强调,需要在持续贫困地区采取有针对性的干预措施.
- 进一步的研究可以为改善弱势群体癌症护理平等的政策提供信息.
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