Inter-country and ethnic variation in colorectal cancer survival: Comparisons between a Philippine population, Filipino-Americans and Caucasians
Inter-country and ethnic variation in colorectal cancer survival: Comparisons between a Philippine population, Filipino-Americans and Caucasians
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DOI：
10.1186/1471-2407-10-100
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发表时间：
2010-03-16
期刊：
影响因子：
3.8
通讯作者：
Brenner, Hermann
中科院分区：
文献类型：
--
作者：
Redaniel, Maria Theresa;Laudico, Adriano;Brenner, Hermann
背景资料：以前基于人群的研究表明，国际和国内结直肠癌生存率估计存在差异，但很少调查预后因素的作用。使用“高分辨率方法”，我们的目的是通过比较菲律宾裔美国人与菲律宾居民，谁拥有相同的种族，并与高加索人生活在美国，谁拥有相同的医疗保健系统，以确定种族和医疗保健的影响。方法：利用马尼拉和黎刹癌症登记处以及美国监测、流行病学和最终结果的数据库，计算年龄校正的5年绝对和相对生存率估计值，并比较菲律宾裔美国人结直肠癌患者、菲律宾癌症患者和白人患者。考克斯比例风险模型被用来确定影响生存differences.Results的因素：低得多的5年相对生存估计菲律宾居民（37%）相比，在菲律宾裔美国人（60.3%）和白人（62.4%）。年龄，阶段和接受手术的差异解释了菲律宾居民和菲律宾裔美国人之间生存差异的很大一部分。然而，强大的过剩的死亡风险为菲律宾居民控制后，这些和其他变量（相对危险度，RR，2.03，95%置信区间，95%CI，1.83-2.25）。结论：强大的生存劣势菲律宾居民相比，菲律宾裔美国患者被披露，这最有可能反映在获得和利用医疗保健的差异。同样，对病人和保健工作者的健康教育和宣传也应该得到优先考虑。
Background: Previous population-based studies showed differences in international and within country colorectal cancer survival estimates, but few investigated the role of prognostic factors. Using a "high resolution approach", we aimed to determine the effect of ethnicity and health care by comparing Filipino-Americans with Philippine residents, who have the same ethnicity, and with Caucasians living in the US, who have the same health care system.Methods: Using databases from the Manila and Rizal Cancer Registries and the United States Surveillance, Epidemiology and End Results, age-adjusted five-year absolute and relative survival estimates were computed and compared between Filipino-American colorectal cancer patients, cancer patients from the Philippines and Caucasian patients. Cox proportional hazards modelling was used to determine factors affecting survival differences.Results: Much lower 5-year relative survival estimates were obtained for Philippine residents (37%) as compared to those in Filipino-Americans (60.3%) and Caucasians (62.4%). Differences in age, stage and receipt of surgery explained a large proportion of the survival differences between Philippine residents and Filipino-Americans. However, strong excess risk of death for Philippine residents remained after controlling for these and other variables (relative risk, RR, 2.03, 95% confidence interval, 95% CI, 1.83-2.25).Conclusions: Strong survival disadvantages of Philippine residents compared to Filipino-American patients were disclosed, which most likely reflect differences in access to and utilization of health care. Health education and advocacy, for both patients and health practitioners, should likewise be given priority.