Neighborhood deprivation and prostate cancer mortality: a multilevel analysis from Sweden
Neighborhood deprivation and prostate cancer mortality: a multilevel analysis from Sweden
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DOI：
10.1038/pcan.2011.46
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发表时间：
2012-06-01
影响因子：
4.8
通讯作者：
Sundquist, J.
中科院分区：
文献类型：
--
作者：
Li, X.;Sundquist, K.;Sundquist, J.
背景技术背景：其目的是分析邻里剥夺和前列腺癌死亡率之间的关联，调整后的个人characteristics.METHODS：本研究被设计为一个随访研究的前列腺癌死亡率在1990年1月1日至2008年12月31日之间的患者年龄在25-74岁（共73159例）。多水平Logistic回归分析进行了个人层面的特点，在第一级和水平的邻里剥夺在第二级level.Results：年龄标准化前列腺癌死亡率是1.5倍，生活在高剥夺的社区比那些生活在最富裕的社区。死亡率还与某些个人层面的特征有关，即年龄、婚姻状况、家庭收入、教育程度、移民状况、城市/农村状况、流动性和合并症。例如，前列腺癌死亡率与未婚、低收入或低教育程度以及因慢性阻塞性肺病住院治疗之间存在密切关系。在完整的模型中，前列腺癌死亡率的风险是25%，生活在最贫困的社区比那些生活在最富裕的neighborhoods.CONCLUSIONS：高水平的邻里剥夺独立预测前列腺癌死亡率。这引起了重要的临床和公共卫生问题。个人和社区层面的方法在医疗保健政策中都很重要。
BACKGROUND: The objective was to analyze the association between neighborhood deprivation and prostate cancer mortality, after adjusting for individual characteristics.METHODS: This study was designed as a follow-up study of prostate cancer mortality between 1 January 1990 and 31 December 2008 in patients aged 25-74 years (a total of 73 159 patients). Multilevel logistic regression analyses were performed with individual-level characteristics at the first level and level of neighborhood deprivation at the second level.RESULTS: The age-standardized prostate cancer mortality rate was 1.5 times higher in men living in high-deprivation neighborhoods than in those living in the most affluent neighborhoods. Mortality rates were also associated with certain individual-level characteristics, that is, age, marital status, family income, educational attainment, immigration status, urban/rural status, mobility and comorbidity. For example, there was a strong relationship between prostate cancer mortality and being unmarried, having a low income or educational attainment, and hospitalization for chronic obstructive pulmonary disease. In the full model, the risk of prostate cancer mortality was 25% higher in men living in the most deprived neighborhoods than in those living in the most affluent neighborhoods.CONCLUSIONS: High level of neighborhood deprivation independently predicts prostate cancer mortality. This raises important clinical and public health concerns. Both individual- and neighborhood-level approaches are important in healthcare policies.