Breast, lung and colorectal cancer incidence and survival in South Thames Region, 1987-1992: the effect of social deprivation
Breast, lung and colorectal cancer incidence and survival in South Thames Region, 1987-1992: the effect of social deprivation
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DOI：
10.1093/oxfordjournals.pubmed.a024632
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发表时间：
1997-09-01
期刊：
影响因子：
--
通讯作者：
Vickers, N
中科院分区：
文献类型：
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作者：
Pollock, AM;Vickers, N
背景本文描述了社会剥夺与南泰晤士地区居民乳腺癌、肺癌和结直肠癌的发病率和生存率之间的关系。我们分析了1987年1月1日至1992年12月31日确诊的乳腺癌23505例，肺癌29903例，结直肠癌21905例，年龄40-99岁。方法采用1991年人口普查和汤森社会剥夺指数，我们根据患者的家庭邮政编码推导出剥夺的替代指标。计算每种癌症的累积相对五年生存率（百分比）。然后，我们比较了我们的结果与相关的标准化的发病率和死亡率比剥夺status.Results一个明确的趋势，观察到标准化的死亡率在剥夺十分之三的肿瘤部位：死亡率增加剥夺。剥夺与肺癌发病率之间存在强正相关（p < 0.0001），但剥夺与乳腺癌和结直肠癌发病率之间没有发现关联。在最贫困的汤森十分之一的人群中，乳腺癌和结肠直肠癌患者的五年相对生存率明显较低。居住在最富裕的十分之一的普查区的乳腺癌患者的相对存活率为70%，而居住在最贫穷的十分之一的普查区的乳腺癌患者的相对存活率为57%。结直肠癌患者的相应数字分别为40%和32%，force.Conclusion生存差异的剥夺状态存在于南泰晤士河之间的患者患有乳腺癌或结直肠癌，并不能解释这些疾病的发病率的差异。对于肺癌，发病率和死亡率与剥夺呈正相关，但没有发现生存的社会经济梯度。
Background This paper describes the relationship between social deprivation and incidence of, and survival from, breast, lung, and colorectal cancers among residents of the South Thames regions. We analysed 23 505 cases of breast cancer, 29 903 cases of lung cancer and 21 905 cases of colorectal cancer, aged 40-99 inclusive at diagnosis and diagnosed between 1 January 1987 and 31 December 1992.Methods Using the 1991 Census in conjunction with the Townsend index on social deprivation, we derived proxy indicators of deprivation based on patients' home postal codes. Cumulative relative five-year survival rates (per cent) were calculated for each cancer. We then compared our results with the relevant standardized incidence and mortality ratios by deprivation status.Results A clear trend was observed in standardized mortality rates across deprivation tenths for the three tumour sites: mortality increased with deprivation. A strong positive correlation was found between deprivation and the incidence of lung cancers (p < 0.0001), but no association was found between deprivation and incidence of breast and colorectal cancers. Significantly lower five-year relative survival rates were found for breast and colorectal cancer patients in the most deprived Townsend tenths. Breast cancer patients resident in the most affluent tenth of enumeration districts had a 70 per cent relative survival ratio compared with 57 per cent in the most deprived tenth. The corresponding figures for colorectal cancer patients were 40 per cent and 32 per cent, respectively.Conclusion Survival differences by deprivation status exist in South Thames among patients suffering from breast or colorectal cancers and are not explained by differences in the incidences of these diseases. For lung cancer, incidence and mortality were positively correlated with deprivation, but no socio-economic gradient was found for survival.