Socioeconomic position and prognosis in premenopausal breast cancer: a population-based cohort study in Denmark.
Socioeconomic position and prognosis in premenopausal breast cancer: a population-based cohort study in Denmark.
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DOI：
10.1186/s12916-021-02108-z
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发表时间：
2021-09-30
期刊：
影响因子：
9.3
通讯作者：
Cronin-Fenton D
中科院分区：
文献类型：
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作者：
Hjorth CF;Damkier P;Ejlertsen B;Lash T;Sørensen HT;Cronin-Fenton D
探讨社会经济地位（SEP）如何影响绝经前乳腺癌患者的乳腺癌复发率和死亡率方面的癌症导向治疗的有效性。我们进行了一项嵌套在ProBeCaRe（乳腺癌复发预测因子）队列（n = 5959）中的队列研究。我们确定了2007-2011年期间丹麦所有18-55岁诊断为非转移性乳腺癌并接受基于紫杉醇化疗的绝经前女性。基于人口的行政登记处提供了有关SEP的数据：婚姻状况（已婚，包括登记伴侣关系，或单身，包括离婚或丧偶）、同居（同居或独居）、教育程度（低、中、高）、收入（低、中、高）和就业状况（就业、失业或与健康相关的缺勤）。对于每个SEP指标，我们计算了发病率、累积发病率比例（CIP），并使用泊松回归计算复发和死亡的发病率比（IRR）和95%置信区间（CI）。我们对雌激素受体（ER）状态/他莫昔芬进行分层，以评估相互作用。我们的研究队列包括2616名女性; 286名（CIP 13%）复发，223名（CIP 11%）在随访期间死亡（中位数分别为6.6年和7.2年）。单身女性的5年复发风险（IRR 1.45，95%CI 1.11-1.89）和死亡率（IRR 1.83，95%CI 1.32-2.52）均增加。此外，我们还观察到，受教育程度低的妇女的5年死亡率增加（内部收益率1.49，95%置信区间0.95-2.33），低收入（内部收益率1.37，95%置信区间0.83-2.28），失业（IRR 1.61，95% CI 0.83-3.13），或健康相关缺勤（IRR 1.80，95% CI 1.14-2.82），但复发风险较小或无复发风险增加。这些发现在服用他莫昔芬的ER+肿瘤患者中尤其明显。总体分析（随访最大值）10年后，他们得到了类似的结果。绝经前非转移性乳腺癌患者的低SEP与死亡率增加相关，但不总是复发。这表明在某些群体中对复发的检测不足。低SEP的妇女，尤其是单身妇女，预后不良，可能部分原因是坚持使用他莫昔芬。在线版本包含补充材料，可通过10.1186/s12916-021-02108-z获得。
To investigate how socioeconomic position (SEP) influences the effectiveness of cancer-directed treatment in premenopausal breast cancer patients in terms of breast cancer recurrence and mortality. We conducted a cohort study nested in the ProBeCaRe (Predictors of Breast Cancer Recurrence) cohort (n = 5959). We identified all premenopausal women aged 18–55 years diagnosed with non-metastatic breast cancer and prescribed docetaxel-based chemotherapy in Denmark during 2007–2011. Population-based administrative registries provided data on SEP: marital status (married including registered partnership or single including divorced or widowed), cohabitation (cohabiting or living alone), education (low, intermediate, or high), income (low, medium, or high), and employment status (employed, unemployed, or health-related absenteeism). For each SEP measure, we computed incidence rates, cumulative incidence proportions (CIPs), and used Poisson regression to compute incidence rate ratios (IRRs) and 95% confidence intervals (CIs) of recurrence and death. We stratified on estrogen receptor (ER) status/tamoxifen to evaluate interaction. Our study cohort included 2616 women; 286 (CIP 13%) experienced recurrence and 223 (CIP 11%) died during follow-up (median 6.6 and 7.2 years, respectively). Single women had both increased 5-year risks of recurrence (IRR 1.45, 95% CI 1.11–1.89) and mortality (IRR 1.83, 95% CI 1.32–2.52). Furthermore, we observed increased 5-year mortality in women with low education (IRR 1.49, 95% CI 0.95–2.33), low income (IRR 1.37, 95% CI 0.83–2.28), unemployment (IRR 1.61, 95% CI 0.83–3.13), or health-related work absenteeism (IRR 1.80, 95% CI 1.14–2.82), but smaller or no increased risk of recurrence. These findings were especially evident among women with ER+ tumors prescribed tamoxifen. Overall analyses (follow-up max. 10 years) provided similar results. Low SEP in premenopausal women with non-metastatic breast cancer was associated with increased mortality, but not always recurrence. This suggests underdetection of recurrences in certain groups. Poor prognosis in women with low SEP, especially single women, may partly be explained by tamoxifen adherence. The online version contains supplementary material available at 10.1186/s12916-021-02108-z.
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影响因子：
--
作者：
Di Salvo F;Caranci N;Spadea T;Zengarini N;Minicozzi P;Amash H;Fusco M;Stracci F;Falcini F;Cirilli C;Candela G;Cusimano R;Tumino R;Sant M;Socioeconomic Inequalities and Oncological Outcomes Italian Working Group
通讯作者：
Socioeconomic Inequalities and Oncological Outcomes Italian Working Group
影响因子：
3.1
作者：
Damkjaer, Lars Henrik;Deltour, Isabelle;Dalton, Susanne Oksbjerg
通讯作者：
Dalton, Susanne Oksbjerg
影响因子：
168.9
作者：
Albain, K.;Anderson, S.;Arriagada, R.;Barlow, W.;Bergh, J.;Bliss, J.;Buyse, M.;Cameron, D.;Carrasco, E.;Clarke, M.;Correa, C.;Coates, A.;Collins, R.;Costantino, J.;Cutter, D.;Cuzick, J.;Darby, S.;Davidson, N.;Davies, C.;Davies, K.;Delmestri, A.;Di Leo, A.;Dowsett, M.;Elphinstone, P.;Evans, V.;Ewertz, M.;Gelber, R.;Gettins, L.;Geyer, C.;Goldhirsch, A.;Godwin, J.;Gray, R.;Gregory, C.;Hayes, D.;Hill, C.;Ingle, J.;Jakesz, R.;James, S.;Kaufmann, M.;Kerr, A.;MacKinnon, E.;McGale, P.;McHugh, T.;Norton, L.;Ohashi, Y.;Paik, S.;Pan, H. C.;Perez, E.;Peto, R.;Piccart, M.;Pierce, L.;Pritchard, K.;Pruneri, G.;Raina, V.;Ravdin, P.;Robertson, J.;Rutgers, E.;Shao, Y. F.;Swain, S.;Taylor, C.;Valagussa, P.;Viale, G.;Whelan, T.;Winer, E.;Wang, Y.;Wood, W.
通讯作者：
Wood, W.
影响因子：
8.4
作者：
Carlsen, Kathrine;Hoybye, Mette Terp;Tjonneland, Anne
通讯作者：
Tjonneland, Anne
影响因子：
6.4
作者：
Dalton, Susanne Oksbjerg;Ross, Lone;Johansen, Christoffer
通讯作者：
Johansen, Christoffer