社会人口边缘化与转移性激素敏感前列腺癌组合疗法之间的关联:加拿大安大略省的人口基队列研究
David-Dan Nguyen1,2, Raj Satkunasivam3, Khatereh Aminoltejari1,4
1Division of Urology, University of Toronto, Toronto, ON, Canada.
JCO oncology practice
|January 13, 2026
概括
边缘化显著减少了对转移性激素敏感前列腺癌 (mHSPC) 延长生命的组合疗法的获得. 政策干预是必要的,以确保为所有mHSPC患者提供公平的护理.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 组合疗法可以改善转移性激素敏感前列腺癌 (mHSPC) 的存活率.
- 这些先进疗法的现实世界使用仍然不够理想.
- 社会人口统计学边缘化在这种护理差距中的作用未得到充分研究.
研究的目的:
- 评估社会人口统计边缘化与mHSPC患者接受组合治疗之间的关联.
- 确定导致mHSPC治疗差异的特定边缘化领域.
主要方法:
- 在加拿大安大略省 (2014-2022) 进行基于人口的队列研究.
- 包括66岁以上的6,051名患者,他们已经接受了新的mHSPC.
- 使用安大略省边缘化指数 (ON-MARG) 来衡量区域级社会经济劣势.
- 层次逻辑回归分析了ON-MARG和组合疗法接收之间的关联.
主要成果:
- 总体边缘化得分较高与接受组合治疗的几率较低有关 (OR,0.91).
- 在种族化和新移民人口 (OR,0.89) 领域观察到的最大差异.
- 与农村居民相比,高收入地区的城市患者接受组合治疗的几率更高 (OR,1.39).
结论:
- 对mHSPC的组合治疗的获取是不公平的,特别是对于边缘化,农村或低收入社区的患者.
- 这些发现凸显了政策干预的必要性,以促进公平获得延长寿命的治疗.
- 确保所有mHSPC患者从治疗进步中受益,需要解决系统性障碍.
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