Racial disparities in diabetes care among incident breast, prostate, and colorectal cancer survivors: a SEER Medicare study.
Racial disparities in diabetes care among incident breast, prostate, and colorectal cancer survivors: a SEER Medicare study.
复制标题
事件乳房，前列腺和结直肠癌幸存者中糖尿病护理的种族差异：一项Seer Medicare研究。
DOI：
10.1007/s11764-021-01003-z
复制
发表时间：
2022-03
影响因子：
3.7
通讯作者：
Safford, Monika M.
中科院分区：
文献类型：
--
作者：
Pinheiro, Laura C.;Soroka, Orysya;Kern, Lisa M.;Higgason, Noel;Leonard, John P.;Safford, Monika M.
许多患有合并糖尿病的癌症幸存者接受的糖尿病管理比非癌症患者少。我们试图确定在乳腺癌、前列腺癌或结直肠癌诊断后12个月内推荐的糖尿病治疗是否存在种族/民族差异。由于合并糖尿病降低长期生存率，因此确定指南一致的糖尿病护理的预测因素非常重要。使用与医疗保险索赔相关的监测，流行病学和最终结果癌症登记处，我们纳入了2008-2013年期间患有糖尿病和非转移性乳腺癌，前列腺癌或结直肠癌的67岁以上受益人。主要结局是诊断后12个月的糖尿病护理服务：1）HbA 1c检测，2）眼科检查，3）低密度脂蛋白（LDL）检测。使用具有稳健标准误的修改后的泊松模型，我们分别检查了每个结果。我们纳入了34，643名患有糖尿病和癌症的医疗保险受益人。诊断时的平均年龄为76.1岁（SD 6.2），47.2%为女性; 35%患有乳腺癌，24%患有结直肠癌，41%患有前列腺癌。在癌症诊断后的12个月内，82.4%的人接受了HbA 1c检测，55.3%的人接受了眼科检查，77.8%的人接受了LDL检测，42.0%的人接受了所有三项检测。与非西班牙裔白人相比，黑人接受HbA 1c检测的可能性低3%（95% CI 0.95-0.98），接受LDL检测的可能性低10%（95% CI 0.89-0.92），接受眼部检查的可能性低8%（95% CI 0.89-0.95）。在考虑混杂因素后，黑人和西班牙裔接受所有三项测试的可能性分别为16%（95%CI 0.81-0.88）和7%（0.88-0.98）。不同癌症类型之间存在种族/民族差异。与非西班牙裔白人相比，患有乳腺癌、前列腺癌、结直肠癌和糖尿病的黑人和西班牙裔人在癌症诊断后接受的糖尿病护理较少。社会经济因素或临床需求无法解释差异。
Many cancer survivors with co-morbid diabetes receive less diabetes management than their non-cancer counterparts. We sought to determine if racial/ethnic disparities exist in recommended diabetes care within 12 months of an incident breast, prostate, or colorectal cancer diagnosis. Because co-morbid diabetes decreases long-term survival, identifying predictors of guideline-concordant diabetes care is important. Using the Surveillance, Epidemiology, and End Results cancer registry linked to Medicare claims, we included beneficiaries aged 67+ years with diabetes and incident, non-metastatic breast, prostate, or colorectal cancer between 2008–2013. Primary outcomes were diabetes care services 12 months after diagnosis: 1) HbA1c test, 2) eye exam, and 3) low-density lipoprotein (LDL) test. Using modified Poisson models with robust standard errors, we examined each outcome separately. We included 34,643 Medicare beneficiaries with both diabetes and cancer. Mean age at diagnosis was 76.1 (SD 6.2), 47.2% were women; 35% had breast, 24% colorectal, and 41% prostate cancer. In the 12 months after incident cancer diagnosis, 82.4% received an HbA1c test, 55.3% received an eye exam, 77.8% had an LDL test, and 42.0% received all three tests. Compared to Non-Hispanic Whites, Blacks were 3% (95% CI 0.95–0.98) less likely to receive a HbA1c test, 10% (95% CI 0.89–0.92) less likely to receive a LDL test, and 8% (95% 0.89–0.95) less likely to receive an exam eye. Blacks and Hispanics were 16% (95% CI 0.81–0.88) and 7% (0.88–0.98) less likely to receive all three tests, after accounting for confounders. Racial/ethnic differences persisted across cancer types. Blacks and Hispanics with breast, prostate, and colorectal cancer and diabetes received less diabetes care after cancer diagnosis compared to Non-Hispanic Whites. Differences were not explained by socio-economic factors or clinical need.
登录
查看更多内容
影响因子：
7.2
作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
通讯作者：
CIOL, MA
影响因子：
45.3
作者：
Guadagnoli, E;Shapiro, C;Soumerai, SB
通讯作者：
Soumerai, SB
DOI：
10.1177/106286069901400607
发表时间：
1999-11-01
期刊：
American journal of medical quality : the official journal of the American College of Medical Quality
影响因子：
--
作者：
Hebert, P L;Geiss, L S;McBean, A M
通讯作者：
McBean, A M
影响因子：
7.2
作者：
Klabunde, CN;Potosky, AL;Warren, JL
通讯作者：
Warren, JL
影响因子：
1.8
作者：
Hershey DS
通讯作者：
Hershey DS