Residential segregation and overall survival of women with epithelial ovarian cancer
Residential segregation and overall survival of women with epithelial ovarian cancer
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DOI：
10.1002/cncr.32989
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发表时间：
2020-06-02
期刊：
影响因子：
6.2
通讯作者：
Balise, Raymond R.
中科院分区：
文献类型：
--
作者：
Westrick, Ashly C.;Bailey, Zinzi D.;Balise, Raymond R.
据作者所知，上皮性卵巢癌（EOC）患者生存差异的病因尚未完全清楚。居住隔离，无论是经济上的还是种族上的，仍然是美国的一个问题。本研究的目的是分析居住隔离的影响，测量的浓度指数在极端（ICE）EOC生存在佛罗里达的种族和/或ethnication.Methods所有恶性EOC病例确定从2001年到2015年使用佛罗里达癌症数据系统（FCDS）。人口普查定义的地方被用作社区的代理。使用美国社区调查的5年估计值，计算了5个ICE变量：经济（高与低），种族和/或民族（非西班牙裔白色[NHW]与非西班牙裔黑人[NHB]和NHW与西班牙裔），以及种族化的经济隔离（低收入NHB与高收入NHW和低收入西班牙裔与高收入NHW）。结果在佛罗里达，在这段时间内，居住在指定的人口普查定义的地方的妇女中，共诊断出16,431例恶性EOC病例。作者发现，在NHB和西班牙裔妇女中，经济和种族化的经济居住隔离比种族和/或种族隔离对EOC生存率的影响更大。NHB妇女继续有一个增加的死亡风险相比，NHW妇女控制多个协变量后，而西班牙裔妇女被发现有一个类似的或降低的死亡风险相比，NHW妇女在多变量考克斯models.Conclusions目前的研究结果表明，种族和经济的居住隔离影响EOC患者的生存。需要研究开发更强大的隔离措施，捕捉社区的复杂性，以充分了解平等机会委员会的生存差距。
Background To the authors' knowledge, the etiology of survival disparities in patients with epithelial ovarian cancer (EOC) is not fully understood. Residential segregation, both economic and racial, remains a problem within the United States. The objective of the current study was to analyze the effect of residential segregation as measured by the Index of Concentration at the Extremes (ICE) on EOC survival in Florida by race and/or ethnicity.Methods All malignant EOC cases were identified from 2001 through 2015 using the Florida Cancer Data System (FCDS). Census-defined places were used as proxies for neighborhoods. Using 5-year estimates from the American Community Survey, 5 ICE variables were computed: economic (high vs low), race and/or ethnicity (non-Hispanic white [NHW] vs non-Hispanic black [NHB] and NHW vs Hispanic), and racialized economic segregation (low-income NHB vs high-income NHW and low-income Hispanic vs high-income NHW). Random effects frailty models were conducted.Results A total of 16,431 malignant EOC cases were diagnosed in Florida among women living in an assigned census-defined place within the time period. The authors found that economic and racialized economic residential segregations influenced EOC survival more than race and/or ethnic segregation alone in both NHB and Hispanic women. NHB women continued to have an increased hazard of death compared with NHW women after controlling for multiple covariates, whereas Hispanic women were found to have either a similar or decreased hazard of death compared with NHW women in multivariable Cox models.Conclusions The results of the current study indicated that racial and economic residential segregation influences survival among patients with EOC. Research is needed to develop more robust segregation measures that capture the complexities of neighborhoods to fully understand the survival disparities in EOC.