Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: National Longitudinal Mortality Study.
Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: National Longitudinal Mortality Study.
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DOI：
10.1007/s10552-008-9256-0
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发表时间：
2009-05
影响因子：
2.3
通讯作者：
Edwards, Brenda K.
中科院分区：
文献类型：
--
作者：
Clegg, Limin X.;Reichman, Marsha E.;Miller, Barry A.;Hankey, Benjamin F.;Singh, Gopal K.;Lin, Yi Dan;Goodman, Marc T.;Lynch, Charles F.;Schwartz, Stephen M.;Chen, Vivien W.;Bernstein, Leslie;Gomez, Scarlett L.;Graff, John J.;Lin, Charles C.;Johnson, Norman J.;Edwards, Brenda K.
关键词：
来自国家癌症研究所(NCI)监测、流行病学和最终结果(SEER)计划的基于人群的癌症登记数据主要基于医疗记录和管理信息。美国的癌症登记机构不会定期报告个人层面的社会经济数据，因为患者的医院记录中没有这些数据。美国代表性的国家纵向死亡率研究(NLMS)数据提供了来自人口普查局当前人口调查(CPS)的社会和经济补充资料的自我报告的详细人口和社会经济数据。1999年，NCI发起了SEER-NLMS研究，将基于人群的SEER癌症登记数据与NLMS数据联系起来。SEER-NLMS数据为癌症负担的健康差异研究提供了一个新的独特的研究资源。我们描述了这个数据集的设计、方法和局限性。我们还根据个人水平的社会经济状况(SES)和所有癌症以及肺癌、乳腺癌、前列腺癌、宫颈癌和黑色素瘤的人口统计特征，提出了与癌症相关的健康差异的研究结果。在1973-2001年间被诊断为癌症患者的记录在11个SEER登记中有1个与26个NLMS队列相关联。同时也是NLMS队列成员的SEER匹配的癌症患者的总数为26,844人。在这26,844名匹配的患者中，11,464名被纳入发病率分析，15,357名被纳入晚期诊断分析。匹配的患者(用于发病率分析)和不匹配的患者按年龄组、性别、种族、民族、居住地、诊断年份和癌症解剖部位进行比较。计算基于队列的年龄调整后的癌症发病率。评估了社会经济状况对癌症发病率和诊断阶段的影响。与受过大学教育的男性和女性相比，受过高中教育的男性和女性的肺癌发病率分别高出3.01和2.02。那些家庭年收入低于12,500美元的人的发病率是收入50,000美元或更高的人肺癌发病率的1.7倍以上。低收入还与女性远端乳腺癌和男性远端前列腺癌的风险在统计上显着增加有关。发病率的社会经济模式因具体癌症而异，而这种分期模式在不同癌症中通常是一致的，晚期诊断与较低的SES相关。这些发现说明了根据各种个体水平的社会经济、人口和医疗保健特征以及链接数据库中可用的面积测量来分析癌症结果差异的可能性。
Population-based cancer registry data from the Surveillance, Epidemiology, and End Results (SEER) Program at the National Cancer Institute (NCI) are mainly based on medical records and administrative information. Individual-level socioeconomic data are not routinely reported by cancer registries in the United States because they are not available in patient hospital records. The U.S. representative National Longitudinal Mortality Study (NLMS) data provide self-reported, detailed demographic and socioeconomic data from the Social and Economic Supplement to the Census Bureau's Current Population Survey (CPS). In 1999, the NCI initiated the SEER-NLMS study, linking the population-based SEER cancer registry data to NLMS data. The SEER-NLMS data provide a new unique research resource that is valuable for health disparity research on cancer burden. We describe the design, methods, and limitations of this data set. We also present findings on cancer-related health disparities according to individual-level socioeconomic status (SES) and demographic characteristics for all cancers combined and for cancers of the lung, breast, prostate, cervix, and melanoma. Records of cancer patients diagnosed in 1973–2001 when residing 1 of 11 SEER registries were linked with 26 NLMS cohorts. The total number of SEER matched cancer patients that were also members of an NLMS cohort was 26,844. Of these 26,844 matched patients, 11,464 were included in the incidence analyses and 15,357 in the late-stage diagnosis analyses. Matched patients (used in the incidence analyses) and unmatched patients were compared by age group, sex, race, ethnicity, residence area, year of diagnosis, and cancer anatomic site. Cohort-based age-adjusted cancer incidence rates were computed. The impact of socioeconomic status on cancer incidence and stage of diagnosis was evaluated. Men and women with less than a high school education had elevated lung cancer rate ratios of 3.01 and 2.02, respectively, relative to their college educated counterparts. Those with family annual incomes less than $12,500 had incidence rates that were more than 1.7 times the lung cancer incidence rate of those with incomes $50,000 or higher. Lower income was also associated with a statistically significantly increased risk of distant-stage breast cancer among women and distant-stage prostate cancer among men. Socioeconomic patterns in incidence varied for specific cancers, while such patterns for stage were generally consistent across cancers, with late-stage diagnoses being associated with lower SES. These findings illustrate the potential for analyzing disparities in cancer outcomes according to a variety of individual-level socioeconomic, demographic, and health care characteristics, as well as by area measures available in the linked database.
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影响因子：
2.3
作者：
Liu, LH;Deapen, D;Bernstein, L
通讯作者：
Bernstein, L
影响因子：
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作者：
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影响因子：
2.3
作者：
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Edwards, Brenda K.
影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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