Socioeconomic Inequalities and Ethnicity Are Associated with a Positive COVID-19 Test among Cancer Patients in the UK Biobank Cohort.
Socioeconomic Inequalities and Ethnicity Are Associated with a Positive COVID-19 Test among Cancer Patients in the UK Biobank Cohort.
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DOI：
10.3390/cancers13071514
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发表时间：
2021-03-25
期刊：
影响因子：
5.2
通讯作者：
Luque-Fernandez MA
中科院分区：
文献类型：
--
作者：
Lee SF;Nikšić M;Rachet B;Sanchez MJ;Luque-Fernandez MA
关于社会经济因素对COVID-19在总体人群中的传播、严重程度和结果的影响，证据有限。此外，迫切需要识别和探索与新发癌症患者（人口中最脆弱的群体之一）中COVID-19疾病相关的最重要社会经济风险因素。根据英国第一波大流行的信息，这项研究的结果为癌症患者的风险分类和分层提供了宝贵的证据。我们确定了COVID-19感染风险增加的癌症患者的临床和社会人口特征。研究结果增加了对疫情对英国最脆弱癌症患者影响的了解，并可为COVID-19的可能治疗和预防策略提供启示，包括未来疫苗接种优先政策。我们探讨了社会经济不平等在COVID-19大流行第一波期间癌症患者发病率中的作用。我们在英国生物库队列中进行了一项病例对照研究，该研究与2020年3月16日至2020年8月23日期间获得的COVID-19检测结果相关。主要的暴露变量是社会经济状况，使用汤森德雷伯指数进行评估。在英国生物库队列的18，917名恶性肿瘤患者中，89人的COVID-19检测呈阳性。COVID-19的总体发病率为每1000例癌症患者中有4.7例（95%CI 3.8-5.8）。与最贫困的癌症患者相比，生活在最贫困地区的癌症患者检测阳性的风险几乎高出三倍（RR 2.6，95%CI 1.1-5.8）。其他独立的风险因素包括少数民族背景、肥胖、失业、吸烟和被诊断患有血液癌症不到五年。英国癌症患者在COVID-19疫情中的社会经济不平等模式持续存在，突显了在疫苗接种计划中优先考虑生活在最贫困地区的癌症患者的必要性。这种对感染风险增加的脆弱癌症患者的社会人口特征分析可以为即将到来的大流行浪潮提供预防战略和政策改进的信息。
There is limited evidence regarding the influence of socioeconomic factors on COVID-19 transmission, severity and outcomes in the overall population. Furthermore, there is an urgent need to identify and explore the most important socioeconomic risk factors associated with the COVID-19 disease among incident cancer patients, one of the most vulnerable groups of the population. Findings from this study provide invaluable evidence needed for risk classification and stratification among incident cancer patients, based on the information from the first pandemic wave in the UK. We identified the clinical and socio-demographic profile of cancer patients at increased risk of COVID-19 infection. The results from the study added knowledge on impact of the pandemic on the most vulnerable cancer patients in the UK, and can shed light on possible treatment and prevention strategies for COVID-19, including future vaccination prioritisation policy. We explored the role of socioeconomic inequalities in COVID-19 incidence among cancer patients during the first wave of the pandemic. We conducted a case-control study within the UK Biobank cohort linked to the COVID-19 tests results available from 16 March 2020 until 23 August 2020. The main exposure variable was socioeconomic status, assessed using the Townsend Deprivation Index. Among 18,917 participants with an incident malignancy in the UK Biobank cohort, 89 tested positive for COVID-19. The overall COVID-19 incidence was 4.7 cases per 1000 incident cancer patients (95%CI 3.8–5.8). Compared with the least deprived cancer patients, those living in the most deprived areas had an almost three times higher risk of testing positive (RR 2.6, 95%CI 1.1–5.8). Other independent risk factors were ethnic minority background, obesity, unemployment, smoking, and being diagnosed with a haematological cancer for less than five years. A consistent pattern of socioeconomic inequalities in COVID-19 among incident cancer patients in the UK highlights the need to prioritise the cancer patients living in the most deprived areas in vaccination planning. This socio-demographic profiling of vulnerable cancer patients at increased risk of infection can inform prevention strategies and policy improvements for the coming pandemic waves.
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