Disparities in cancer outcomes across age, sex, and race/ethnicity among patients with pancreatic cancer.
Disparities in cancer outcomes across age, sex, and race/ethnicity among patients with pancreatic cancer.
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DOI：
10.1002/cam4.1277
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发表时间：
2018-03
期刊：
影响因子：
4
通讯作者：
Hur C
中科院分区：
文献类型：
--
作者：
Nipp R;Tramontano AC;Kong CY;Pandharipande P;Dowling EC;Schrag D;Hur C
年龄、性别和种族/民族差异存在，但在胰腺癌(PDAC)中研究不足。我们使用监测、流行病学和最终结果(SEER)-医疗保险关联数据库来确定在根据人口统计学和临床特征进行调整后，存活率和治疗差异是否持续存在。我们的研究包括1992至2011年间确诊的PDAC患者。我们使用COX回归来比较早期和晚期癌症亚组中跨年龄、性别和种族/民族的生存率，调整了婚姻状况、城市位置、社会经济、SEER地区、合并症、分期、淋巴结状况、肿瘤位置、肿瘤分级、诊断年份和接受的治疗。我们使用Logistic回归来比较不同年龄、性别和种族/民族接受治疗的差异。在20896名患者中，84%是白人，9%是黑人，5%是亚洲人，2%是西班牙人。中位年龄为75岁；56%为女性，53%患有晚期癌症。在调整COX模型的早期患者中，年龄较大的患者亚组与66-69岁的患者相比，生存率更差(HR；69；组为1.1，P<；69组为0.01)；性别之间没有生存差异。黑人(HR=1.1P=0.01.)和西班牙裔(HR=1.2P<；00.01)患者的存活率比白人差。在晚期癌症患者中，84岁以上患者的存活率比66-69岁的患者差(HR=61.1，P<0.01)，男性(HR=1.08，P<0.01)的存活率比女性差，没有种族/民族差异。年龄较大和少数族裔/民族与接受化疗、放疗和/或手术的可能性较低有关。对于PDAC患者，在生存结果和接受治疗方面存在年龄和种族/民族差异；在调整了人口统计学和临床特征的差异后，这些差异仍然存在。
Age, sex, and racial/ethnic disparities exist, but are understudied in pancreatic adenocarcinoma (PDAC). We used the Surveillance, Epidemiology, and End Results (SEER)–Medicare linked database to determine whether survival and treatment disparities persist after adjusting for demographic and clinical characteristics. Our study included PDAC patients diagnosed between 1992 and 2011. We used Cox regression to compare survival across age, sex, and race/ethnicity within early‐stage and late‐stage cancer subgroups, adjusting for marital status, urban location, socioeconomics, SEER region, comorbidities, stage, lymph node status, tumor location, tumor grade, diagnosis year, and treatment received. We used logistic regression to compare differences in treatment received across age, sex, and race/ethnicity. Among 20,896 patients, 84% were White, 9% Black, 5% Asian, and 2% Hispanic. Median age was 75; 56% were female and 53% had late‐stage cancer. Among early‐stage patients in the adjusted Cox model, older patient subgroups had worse survival compared with ages 66–69 (HR > 1.1, P < 0.01 for groups >69); no survival differences existed between sexes. Black (HR = 1.1, P = 0.01) and Hispanic (HR = 1.2, P < 0.01) patients had worse survival compared with White. Among late‐stage cancer patients, patients over age 84 had worse survival than those aged 66–69 (HR = 1.1, P < 0.01), and males (HR = 1.08, P < 0.01) had worse survival than females; there were no racial/ethnic differences. Older age and minority race/ethnicity were associated with lower likelihood of receiving chemotherapy, radiation, and/or surgery. Age and racial/ethnic disparities in survival outcomes and treatment received exist for PDAC patients; these disparities persist after adjusting for differences in demographic and clinical characteristics.
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影响因子：
7.2
作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
通讯作者：
CIOL, MA
影响因子：
3.8
作者：
Dias-Santos, Daniela;Ferrone, Cristina R.;Fernandez-del Castillo, Carlos
通讯作者：
Fernandez-del Castillo, Carlos
影响因子：
2.9
作者：
Nipp, Ryan D.;Zanconato, Andrea;Fernandez-del Castillo, Carlos
通讯作者：
Fernandez-del Castillo, Carlos
影响因子：
45.3
作者：
Krzyzanowska, MK;Weeks, JC;Earle, CC
通讯作者：
Earle, CC
DOI：
10.1158/1055-9965.epi-12-1183-t
发表时间：
2013-03
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Poole EM;Merritt MA;Jordan SJ;Yang HP;Hankinson SE;Park Y;Rosner B;Webb PM;Cramer DW;Wentzensen N;Terry KL;Tworoger SS
通讯作者：
Tworoger SS