The influence of neighborhood socioeconomic status and race on survival from ovarian cancer: a population-based analysis of Cook County, Illinois.
The influence of neighborhood socioeconomic status and race on survival from ovarian cancer: a population-based analysis of Cook County, Illinois.
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DOI：
10.1016/j.annepidem.2015.03.021
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发表时间：
2015-08
影响因子：
5.6
通讯作者：
Joslin CE
中科院分区：
文献类型：
--
作者：
Brewer KC;Peterson CE;Davis FG;Hoskins K;Pauls H;Joslin CE
尽管卵巢癌的治疗有显著改善，但非西班牙裔黑人（NHB）妇女的生存率低于非西班牙裔白色（NHW）妇女。社区社会经济地位（SES）与各种健康结果的种族差异有关，也可能同样导致卵巢癌生存率的种族差异。本分析的目的是评估在考虑肿瘤特征和治疗差异后，社区SES对NHB-NHW生存差异的影响。数据来自1998年至2007年伊利诺伊州库克县诊断为上皮性卵巢癌的2432名妇女（443名NHB和1989名NHW）。邻居（即，在诊断时，使用两个完善的富裕和不利的复合措施计算每个妇女的SES。考克斯比例风险模型测量了调整年龄、肿瘤特征、治疗、诊断年份和社区SES后NHB种族与生存率之间的关系。卵巢癌的生存率与社区SES的两个指标之间有很强的相关性（富裕和贫困的P <0.0001）。在调整年龄、肿瘤特征、治疗和诊断年份后，NHB比NHW更可能死于卵巢癌（风险比[HR] = 1.47，95%置信区间[CI]：1.28-1.68）。将社区富裕和劣势分别和一起纳入模型中可降低该风险（HR富裕= 1.37，95% CI：1.18 - 1.58; HR劣势= 1.28，95% CI：1.08-1.52; HR富裕+劣势= 1.28，95% CI：1.08-1.52）。社区社会经济地位，作为衡量的富裕和不利的综合措施，是一个预测生存在库克县，伊利诺伊州诊断为卵巢癌的妇女，并可能有助于生存的种族差异。
Despite significant improvements in treatment for ovarian cancer, survival is poorer for non-Hispanic black (NHB) women compared to non-Hispanic white (NHW) women. Neighborhood socioeconomic status (SES) has been implicated in racial disparities across a variety of health outcomes and may similarly contribute to racial disparities in ovarian cancer survival. The purpose of this analysis is to assess the influence of neighborhood SES on NHB-NHW survival differences after accounting for differences in tumor characteristics and in treatment. Data were obtained from 2432 women (443 NHB and 1989 NHW) diagnosed with epithelial ovarian cancer in Cook County, Illinois between 1998 and 2007. Neighborhood (i.e., census tract) SES at the time of diagnosis was calculated for each woman using two well-established composite measures of affluence and disadvantage. Cox proportional hazard models measured the association between NHB race and survival after adjusting for age, tumor characteristics, treatment, year of diagnosis, and neighborhood SES. There was a strong association between ovarian cancer survival and both measures of neighborhood SES (P < .0001 for both affluence and disadvantage). After adjusting for age, tumor characteristics, treatment, and year of diagnosis, NHB were more likely than NHW to die of ovarian cancer (hazard ratio [HR] = 1.47, 95% confidence interval [CI]: 1.28–1.68). The inclusion of neighborhood affluence and disadvantage into models separately and together attenuated this risk (HRaffluence = 1.37, 95% CI: 1.18 –1.58; HRdisadvantage = 1.28, 95% CI: 1.08–1.52; and HRaffluence + disadvantage = 1.28, 95% CI: 1.08–1.52. Neighborhood SES, as measured by composite measures of affluence and disadvantage, is a predictor of survival in women diagnosed with ovarian cancer in Cook County, Illinois and may contribute to the racial disparity in survival.
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影响因子：
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通讯作者：
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