Cross-Sectional Analysis of the Associations Between Four Common Cancers and Disability.
Cross-Sectional Analysis of the Associations Between Four Common Cancers and Disability.
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四种常见癌症与残疾之间关联的横断面分析。
DOI：
10.6004/jnccn.2020.7551
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发表时间：
2020-08
期刊：
影响因子：
--
通讯作者：
El-Jawahri A
中科院分区：
文献类型：
--
作者：
Iezzoni LI;Rao SR;Agaronnik ND;El-Jawahri A
大约有6100万美国人患有残疾。很少有研究探讨残疾是否与随后的癌症诊断有关，癌症是美国第二大死亡原因。对全国代表性调查的分析;使用抽样权重，分析产生全国估计数。平民，非制度化的美国居民回应2010-2017年全国健康访谈调查。259，392名成人核心调查受访者样本。自我报告的功能状态限制，以确定有运动困难（MD），复杂活动限制（CAL）和无残疾的人。预测癌症诊断的多变量回归包括社会人口学特征、烟草使用、体重指数、获得护理指标和残疾状况。患有既往残疾的人的癌症发病率（范围从卵巢癌的0.40 [SE = 0.05]到前列腺癌的3.38 [0.10]）明显高于无残疾的人（对于相同的癌症，0.20 [0.02]和1.26 [0.04]，所有p值均< 0.0001）。多变量分析发现，既存MD和CAL与结直肠癌有很强的相关性：校正比值比（AORs）（95%CI）分别为1.5（1.2 - 1.9）和1.9（1.5 - 2.4）。对于非霍奇金淋巴瘤，CAL的AOR = 1.5（1.1 - 2.1）。对于前列腺癌，MD的AOR = 1.2（1.0 - 1.3），CAL的AOR = 1.1（1.0 - 3.0）。使用横断面调查数据，我们只能确定统计学关联，而不是因果关系。我们基于人口的分析表明，残疾人可能构成癌症发病率较高的高危人群。因此，优化适当的筛查和充分调查新的体征和症状对残疾患者至关重要。
Roughly 61 million Americans have a disability. Little research has explored whether disability is associated with subsequent diagnosis of cancer, the second-leading cause of death in the U.S. To explore associations between cancer and disability, focusing on four cancers that can present with nonspecific symptoms that could be conflated with aspects of disability, thus delaying cancer diagnoses. Analysis of nationally-representative survey; using sampling weights, analyses produce national estimates. Civilian, non-institutionalized U.S. residents responding to the 2010-2017 National Health Interview Surveys. 259,392 Sample Adult Core survey respondents. Self-reported functional status limitations to identify persons with movement difficulties (MD), complex activity limitations (CAL), and no disability. Multivariable regressions predicting cancer diagnosis included sociodemographic characteristics, tobacco use, body mass index, access to care indicators, and disability status. Persons with pre-existing disability had significantly higher rates of cancer (ranging from 0.40 [SE = 0.05] for ovarian to 3.38 [0.10] for prostate) than did those without disability (0.20 [0.02] and 1.26 [0.04] for the same cancers, all p values < 0.0001). Multivariable analyses found strong associations of pre-existing MD and CAL with colorectal cancer: adjusted odds ratios (AORs) (95% CI) = 1.5 (1.2 - 1.9) and 1.9 (1.5 - 2.4), respectively. For non-Hodgkin lymphoma, AOR for CAL = 1.5 (1.1 - 2.1). For prostate cancer, AORs for MD = 1.2 (1.0 - 1.3) and 1.1 (1.0 - 3.0) for CAL. Using cross-sectional survey data, we could only identify statistical associations, not causality. Our population-based analyses suggest that persons with disability may constitute a high-risk population, with higher cancer incidence. Optimizing appropriate screening and fully investigating new signs and symptoms are therefore critical for patients with disability.
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影响因子：
2.3
作者：
Krieger, N
通讯作者：
Krieger, N
影响因子：
6.2
作者：
Mullins, Megan A.;Peres, Lauren C.;Cote, Michele L.
通讯作者：
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影响因子：
4.5
作者：
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通讯作者：
Rao, Sowmya R.
DOI：
10.1016/j.pmr.2009.12.012
发表时间：
2010-05-01
影响因子：
1.7
作者：
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通讯作者：
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影响因子：
5.5
作者：
Iezzoni, Lisa I.;Kurtz, Stephen G.;Rao, Sowmya R.
通讯作者：
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