Mortality rates due to gynecologic cancers in New York state by demographic factors and proximity to a Gynecologic Oncology Group member treatment center: 1979-2001
Mortality rates due to gynecologic cancers in New York state by demographic factors and proximity to a Gynecologic Oncology Group member treatment center: 1979-2001
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DOI：
10.1016/j.ygyno.2009.03.033
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发表时间：
2009-08-01
影响因子：
4.7
通讯作者：
Carter, Randy L.
中科院分区：
文献类型：
--
作者：
Tan, Wei;Stehman, Frederick B.;Carter, Randy L.
目标。描述纽约州宫颈癌、子宫内膜癌和卵巢癌死亡率的趋势，并评估这些死亡率如何随综合癌症治疗中心的距离或人口密度(农村/城市)而变化。数据来自疾病控制和预防中心的S压缩死亡文件、人口普查局记录和在线地图。泊松回归模型被用来估计因妇科癌症类型而导致的死亡率(平均每10万名妇女每年死亡人数)。在控制了种族、县收入水平和死亡年龄的情况下，比较了驾车前往最近的综合癌症治疗中心的时间和人口密度的死亡率趋势。随着时间的推移，宫颈和子宫内膜的死亡率下降，但卵巢死亡率没有下降。对于宫颈癌和子宫内膜癌，死亡率随着开车时间的不同以及农村和城市县之间的差异而显著不同。就宫颈癌而言，随着时间的推移，农村地区的下降幅度比城市县更大。对于子宫内膜癌，随着距离治疗中心的距离增加，下降幅度更大。1979年至2001年，宫颈癌和子宫内膜癌死亡率有所改善，这是由于妇科癌症治疗研究工作的增加、为治疗此类病例而培训的专家人数的增加，以及在对一般医生的培训中对妇科癌症的重视。我们的结果与一种解释是一致的，即在20世纪60年代末S和70年代初S期间，妇科肿瘤专业领导人的进步行动促进了随后几十年死亡率的改善。(C)2009 Elsevier Inc.保留所有权利。
Objective. To describe trends in mortality rates, in New York State, due to cervical, endometrial and ovarian cancer and to assess how these rates varied with proximity to a comprehensive cancer treatment center or population density (rural/urban).Methods. Data were obtained from the Centers for Disease Control and Prevention (CDC)'s Compressed Mortality Files, Census Bureau records, and online maps. Poisson regression models were fitted to estimate death rates (mean number of deaths per 100,000 women per year) due to gynecologic cancer type. Trends in death rates were compared with respect to driving time to the nearest comprehensive cancer treatment center and population density, controlling for race, county income level, and age at death.Results. Cervical and endometrial but not ovarian death rates declined over time. For both cervical and endometrial cancers, death rates varied significantly with driving time and between rural and urban counties. in the case of cervical cancer, the decline over time was steeper in rural than in urban counties. For endometrial cancer, the decline steepened with increasing distance from a treatment center.Conclusion. Improvements in cervical and endometrial cancer mortality from 1979 to 2001 followed increases in gynecologic cancer treatment research efforts, number of specialists trained to treat such cases, and in the emphasis on gynecologic cancer in the training of physicians in general. Our results are consistent with an interpretation that the progressive actions by leaders in the gynecologic oncology profession during the late 1960's and early 1970's contributed to improvements in mortality rates in subsequent decades. (C) 2009 Elsevier Inc. All rights reserved.