Disparities Contributing to Late-Stage Diagnosis of Lung, Colorectal, Breast, and Cervical Cancers: Rural and Urban Poverty in Florida.
Disparities Contributing to Late-Stage Diagnosis of Lung, Colorectal, Breast, and Cervical Cancers: Rural and Urban Poverty in Florida.
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DOI：
10.3390/cancers15215226
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发表时间：
2023-10-31
期刊：
影响因子：
5.2
通讯作者：
Guo, Yi
中科院分区：
文献类型：
--
作者：
Hall, Jaclyn M.;Mkuu, Rahma S.;Cho, Hee Deok;Woodard, Jennifer N.;Kaye, Frederic J.;Bian, Jiang;Shenkman, Elizabeth A.;Guo, Yi
尽管癌症筛查取得了进展，但晚期癌症诊断仍然是美国发病率和死亡率的主要原因。在这项研究中，我们的目的是了解与接受肺癌，结直肠癌，乳腺癌或宫颈癌晚期诊断相关的人口统计学和地理因素，这四种癌症具有有效的筛查方案。我们发现，除了大量研究表明农村与获得筛查的近端障碍相关外，城市贫困也与被诊断患有晚期疾病显着相关。城市贫困社区在获得癌症筛查方面遇到独特的障碍。尽管癌症筛查取得了进展，但晚期癌症诊断仍然是美国发病率和死亡率的主要原因。在这项研究中，我们的目的是了解与接受肺癌，结直肠癌，乳腺癌或宫颈癌晚期诊断（LSD）相关的人口统计学和地理因素。(1)研究方法：我们分析了2016年至2020年期间来自佛罗里达癌症数据系统（FCDS）的癌症诊断患者的数据，FCDS是一个全州范围内基于人口的登记处。为了研究LSD的相关性，我们估计了每种癌症的多变量logistic回归模型，同时控制了年龄，性别，种族，保险和人口普查区农村和贫困。(2)结果如下：来自高贫困农村地区的患者发生肺癌（OR = 1.23，95%CI（1.10，1.37））和乳腺癌（OR = 1.31，95%CI（1.17，1.47））的风险高于来自低贫困城市地区的患者。高贫困城市地区的患者在肺癌（OR = 1.05，95% CI（1.00，1.09））、乳腺癌（OR = 1.10，95% CI（1.06，1.14））和宫颈癌（OR = 1.19，95% CI（1.03，1.37））中的LSD风险较高。(3)结论：财政障碍，减少获得护理可能驱动LSD的癌症在农村和城市社区的佛罗里达。
Despite advances in cancer screening, late-stage cancer diagnosis is still a major cause of morbidity and mortality in the United States. In this study, we aim to understand demographic and geographic factors associated with receiving a late-stage diagnosis of lung, colorectal, breast, or cervical cancer, four cancers that have efficacious screening protocols. We find that in addition to the large body of research showing rurality is associated with proximal barriers to accessing screening, urban poverty was also significantly associated with being diagnosed with late-stage disease. Communities of urban poverty experience unique barriers to accessing cancer screening. Despite advances in cancer screening, late-stage cancer diagnosis is still a major cause of morbidity and mortality in the United States. In this study, we aim to understand demographic and geographic factors associated with receiving a late-stage diagnosis (LSD) of lung, colorectal, breast, or cervical cancer. (1) Methods: We analyzed data of patients with a cancer diagnosis between 2016 and 2020 from the Florida Cancer Data System (FCDS), a statewide population-based registry. To investigate correlates of LSD, we estimated multi-variable logistic regression models for each cancer while controlling for age, sex, race, insurance, and census tract rurality and poverty. (2) Results: Patients from high-poverty rural areas had higher odds for LSD of lung (OR = 1.23, 95% CI (1.10, 1.37)) and breast cancer (OR = 1.31, 95% CI (1.17,1.47)) than patients from low-poverty urban areas. Patients in high-poverty urban areas saw higher odds of LSD for lung (OR = 1.05 95% CI (1.00, 1.09)), breast (OR = 1.10, 95% CI (1.06, 1.14)), and cervical cancer (OR = 1.19, 95% CI (1.03, 1.37)). (3) Conclusions: Financial barriers contributing to decreased access to care likely drive LSD for cancer in rural and urban communities of Florida.
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