Influence of occupation and education level on breast cancer stage at diagnosis, and treatment options in China: A nationwide, multicenter 10-year epidemiological study.
Influence of occupation and education level on breast cancer stage at diagnosis, and treatment options in China: A nationwide, multicenter 10-year epidemiological study.
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DOI：
10.1097/md.0000000000006641
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发表时间：
2017-04
期刊：
影响因子：
1.6
通讯作者：
Wang K
中科院分区：
文献类型：
--
作者：
Liu Y;Zhang J;Huang R;Feng WL;Kong YN;Xu F;Zhao L;Song QK;Li J;Zhang BN;Fan JH;Qiao YL;Xie XM;Zheng S;He JJ;Wang K
本研究的目的是评估中国女性乳腺癌患者的职业和文化程度对其诊断时的癌症分期、临床和病理特征、实施率和治疗选择的影响。对1999 - 2008年全国7个乳腺癌中心4211例确诊女性乳腺癌病例的病历资料进行回顾性分析。数据包括患者的社会人口学状况，临床和病理特征，临床检查和治疗方式的实施进行了分析。同时，不同职业和教育程度之间的关联进行了分析，通过TNM分期，临床和病理特征，临床检查的实施，和治疗模式的肿瘤分期。采用多因素Logistic回归分析患者的职业和文化程度是否为TNM分期的独立影响因素。不同职业、文化程度的患者在病理特征和治疗选择方面存在显著差异。患者的职业和文化程度是影响TNM分期的独立因素。对于低收入职业或低教育程度组的患者，肿瘤分期较晚，相关检查的实施率较低，放疗、化疗和内分泌治疗的实施率也较低。这项研究表明，战略应致力于制定更准确和有效的乳腺癌预防和治疗策略，专门针对患者的教育程度较低，在特定的职业群体。
The objective of this study was to evaluate the impact of occupation and education level of Chinese female breast cancer patients on their cancer staging at diagnosis, clinical and pathological features, rate of implementation, and selection of treatment. The medical charts of 4211 confirmed female breast cancer cases diagnosed between 1999 and 2008, from 7 breast cancer centers spread across the whole of China, were reviewed. Data including information on the patient's sociodemographic status, clinical and pathological characteristics, implementation of clinical examination and treatment modalities were analyzed. In parallel, the associations between different occupations and level of educational attainment were analyzed in relation to tumor stage through TNM staging, clinical and pathological characteristics, implementation of clinical examination, and treatment patterns. Multivariate logistic regression was used to identify whether the occupation and education level of patients are independent factors of TNM staging at diagnosis. There were significant differences among different occupation groups and the education level of patients in regards to pathological characteristics and treatment choice. Both the occupation and education level of patients were independent factors of TNM staging at diagnosis. For patients within the lower-income occupation or lower educational attainment group, the tumor stage was later, the rates of implementation of relevant investigations were lower, as were the rates of radiotherapy, chemotherapy, and endocrine therapy. This study suggests that strategies should work toward developing more accurate and effective breast cancer prevention and treatment strategies aimed specifically at patients with lower educational attainment levels and at specific occupation groups.