Socioeconomic and geographic determinants of survival of patients with digestive cancer in France
Socioeconomic and geographic determinants of survival of patients with digestive cancer in France
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DOI：
10.1038/sj.bjc.6603335
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发表时间：
2006-10-09
影响因子：
8.8
通讯作者：
Launoy, G.
中科院分区：
文献类型：
--
作者：
Dejardin, O.;Remontet, L.;Launoy, G.
使用多级 Cox 模型，对 1980 年至 1997 年间诊断并在法国癌症登记网络 12 个登记处登记的 81 268 名消化道癌症患者进行了社会经济和地理总体变量与生存之间的关联调查。这种关联因癌症部位而异：对于结肠来说，很明显（相对风险 (RR) 分别为 1.10 (1.04 - 1.16)、1.10 (1.04 - 1.16) 和 1.14 (1.05 - 1.23)），与距离最近的参考癌症护理中心的距离在 10 至 30 公里、30 至 50 公里以及超过 90 公里相比，距离小于10 公里；P 趋势 0.003）和直肠癌（对于 10 至 30 公里、30 至 50 公里以及 50 至 70 公里的距离，分别为 RR = 1.09 (1.03 - 1.15)、RR 1.08 (1.02 - 1.14) 和 RR = 1.12 (1.05 - 1.19)， P 趋势 = 0.024）（分别为 n = 28010 和 n = 18080），但对于胆囊癌和胆道癌 (n = 2893) 或小肠癌 (n = 1038) 不显着。尽管与组织学或诊断分期等临床预后因素相比，社会经济状况对预后的影响不大，但社会经济剥夺和距最近癌症中心的距离需要被视为消化道癌症潜在的生存预测因素。
Using a multilevel Cox model, the association between socioeconomic and geographical aggregate variables and survival was investigated in 81 268 patients with digestive tract cancer diagnosed in the years 1980 - 1997 and registered in 12 registries in the French Network of Cancer Registries. This association differed according to cancer site: it was clear for colon (relative risk (RR) 1.10 (1.04 - 1.16), 1.10 (1.04 - 1.16) and 1.14 (1.05 - 1.23), respectively, for distances to nearest reference cancer care centre between 10 and 30, 30 and 50 and more than 90 km, in comparison with distance of less than 10 km; P-trend 0.003) and rectal cancer (RR = 1.09 (1.03 - 1.15), RR 1.08 (1.02 - 1.14) and RR = 1.12 (1.05 - 1.19), respectively, for distances between 10 and 30 km, 30 and 50 km and 50 and 70 km, P-trend = 0.024) (n = 28010 and n = 18080, respectively) but was not significant for gall bladder and biliary tract cancer (n = 2893) or small intestine cancer (n = 1038). Even though the influence of socioeconomic status on prognosis is modest compared to clinical prognostic factors such as histology or stage at diagnosis, socioeconomic deprivation and distance to nearest cancer centre need to be considered as potential survival predictors in digestive tract cancer.