Disparities in Access to Sorafenib in Communities with Low Socioeconomic Status.
Disparities in Access to Sorafenib in Communities with Low Socioeconomic Status.
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DOI：
10.1353/hpu.2018.0083
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发表时间：
2018
影响因子：
1.4
通讯作者：
Gany F
中科院分区：
文献类型：
--
作者：
Sarpel U;Heskel M;Spivack JH;Feferman Y;Ang C;Gany F
在美国，肝细胞癌（HCC）在社会经济地位（SES）较低的社区中更常见，这些群体往往被诊断为晚期癌症。索拉非尼是晚期HCC的主要治疗方法，但其高昂的费用引起了人们对治疗途径的担忧。新开发的病例-背景方法用于估计各种社会人口学因素对临床合格患者使用索拉非尼的影响的比值比。社会经济地位被定义为基于居住地邮政编码的中等收入和教育水平的因素。索拉非尼处方和居住在一个较高的社会经济地位的地区之间有很强的关联。在控制年龄、种族和保险状况的同时，高SES居住地使索拉非尼处方的几率加倍（OR=2.05，p<0.01）。社会经济地位低的社区似乎接受晚期HCC唯一有效治疗的机会减少。
In the United States, hepatocellular carcinoma (HCC) is more common among communities with low socioeconomic status (SES), and these groups tend to be diagnosed with later-stage cancers. Sorafenib is the primary treatment for advanced HCC, however its substantial cost raises concern for access to treatment. The newly developed Case-Background method was used to estimate odds ratios for the impacts of various sociodemographic factors on sorafenib access in clinically eligible patients. Sociceconomic status was defined as a factor of median income and education level based on ZIP code of residence. There was a strong association between sorafenib prescription and residence in an area of higher SES. While controlling for age, race/ethnicity, and insurance status, high SES residence doubled the odds of sorafenib prescription (OR=2.05, p<.01). Low socioeconomic status communities appear to have a reduced chance of receiving the only effective treatment for advanced HCC.
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