Are deprivation-specific cancer survival patterns similar according to individual-based and area-based measures? A cohort study of patients diagnosed with five malignancies in England and Wales, 2008-2016.
Are deprivation-specific cancer survival patterns similar according to individual-based and area-based measures? A cohort study of patients diagnosed with five malignancies in England and Wales, 2008-2016.
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DOI：
10.1136/bmjopen-2021-058411
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发表时间：
2022-06-10
期刊：
影响因子：
2.9
通讯作者：
Ingleby, Fiona C.
中科院分区：
文献类型：
--
作者：
Woods, Laura M.;Belot, Aurelien;Atherton, Iain M.;Ellis-Brookes, Lucy;Baker, Matthew;Ingleby, Fiona C.
调查当使用基于个人（“人”）与基于地区（“地点”）的三个社会经济层面（收入、剥夺和职业）剥夺措施时，癌症生存率的测量不平等是否不同。队列研究。数据来自英国英格兰和威尔士国家统计局纵向研究，与国家癌症登记数据库相关联。在2008-2016年期间被诊断患有结肠直肠癌、乳腺癌、前列腺癌、膀胱癌或非霍奇金淋巴瘤的患者。通过个人工资、职业和教育定义的群体之间的净生存率差异，与使用英格兰和威尔士多重死亡率指数从相应地区一级指标获得的差异进行比较。无论分析的类型如何，生存与基于地区的贫困呈负相关，尽管并不总是观察到从最少到最多的贫困趋势。社会经济差异存在根据个人测量的社会经济群体，虽然没有一个一致的“梯度”的生存。按地区和按个人计算的贫困程度的差别幅度相似，这是出乎意料的。这些独特的数据表明，“人”的社会经济影响与“地方”对癌症结果的影响不同。这对旨在减少不平等的卫生政策产生了影响。进一步的研究可以考虑基于地区的剥夺对个人层面特征的单独和额外影响（背景效应），并调查结果不佳地区的地理、社会经济和保健相关特征，以便为政策干预提供信息。
To investigate if measured inequalities in cancer survival differ when using individual-based (‘person’) compared with area-based (‘place’) measures of deprivation for three socioeconomic dimensions: income, deprivation and occupation. Cohort study. Data from the Office for National Statistics Longitudinal Study of England and Wales, UK, linked to the National Cancer Registration Database. Patients diagnosed with cancers of the colorectum, breast, prostate, bladder or with non-Hodgkin’s lymphoma during the period 2008–2016. Differentials in net survival between groups defined by individual wage, occupation and education compared with those obtained from corresponding area-level metrics using the English and Welsh Indices of Multiple Deprivation. Survival was negatively associated with area-based deprivation irrespective of the type analysed, although a trend from least to most deprived was not always observed. Socioeconomic differences were present according to individually-measured socioeconomic groups although there was an absence of a consistent ‘gradient’ in survival. The magnitude of differentials was similar for area-based and individually-derived measures of deprivation, which was unexpected. These unique data suggest that the socioeconomic influence of ‘person’ is different to that of ‘place’ with respect to cancer outcomes. This has implications for health policy aimed at reducing inequalities. Further research could consider the separate and additional influence of area-based deprivation over individual-level characteristics (contextual effects) as well as investigate the geographic, socioeconomic and healthcare-related characteristics of areas with poor outcomes in order to inform policy intervention.
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影响因子：
3.7
作者：
Afshar, Nina;English, Dallas R.;Milne, Roger L.
通讯作者：
Milne, Roger L.
DOI：
10.1016/j.ssmph.2021.100815
发表时间：
2021-06
期刊：
SSM - population health
影响因子：
--
作者：
Ingleby FC;Woods LM;Atherton IM;Baker M;Elliss-Brookes L;Belot A
通讯作者：
Belot A
影响因子：
2.9
作者：
Ingleby FC;Belot A;Atherton I;Baker M;Elliss-Brookes L;Woods LM
通讯作者：
Woods LM
影响因子：
2.6
作者：
DeRouen, Mindy C.;Schupp, Clayton W.;Gomez, Scarlett L.
通讯作者：
Gomez, Scarlett L.
影响因子：
2.6
作者：
Nunez, Olivier;Rodriguez Barranco, Miguel;Sanchez, Maria-Jose
通讯作者：
Sanchez, Maria-Jose