The relationship between ethnicity, social deprivation and late presentation of colorectal cancerle
The relationship between ethnicity, social deprivation and late presentation of colorectal cancerle
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DOI：
10.1016/j.canep.2017.01.007
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发表时间：
2017-04-01
影响因子：
2.6
通讯作者：
Faiz, Omar
中科院分区：
文献类型：
--
作者：
Askari, Alan;Nachiappan, Subramanian;Faiz, Omar
引言：肿瘤分期是决定结直肠癌生存率的重要因素。本文的目的是探讨种族和剥夺在晚期（第四阶段）的大肠癌presentation of colorectal cancer.Methods：数据从泰晤士癌症登记处包括77，057结直肠癌患者在2000年和2012年之间进行了分析。结果：共有17，348例患者被确定为完整的数据，其中53.9%是男性。来自非洲/加勒比黑人背景的患者被诊断为CRC的年龄比白色英国组要小得多（中位年龄67岁与72岁相比，p < 0.001）。在多元回归分析中，种族、贫困和年龄是诊断时出现晚期肿瘤的积极预测因素。黑人患者比白色患者更可能出现IV期肿瘤（OR 1.37，95% CI 1.18-1.59，p < 0.001）。社会剥夺也是IV期癌症表现的预测因子，与最富裕的组相比，最剥夺的组（五分位数5）被诊断为IV期癌症的可能性高1.26倍（CI 1.13-1.40，p < 0.001）。亚组分析表明，黑人和富裕人群患IV期CRC的风险仍高于白色和富裕人群（OR 1.24，95%CI 1.111.45，p = 0.023）。直肠癌患者出现IV期CRC的可能性较低（OR 0.66，95% CI 0.61-0.71，p < 0.001）。结论：在英国，肿瘤表现存在种族和年龄相关的差异。来自黑人和社会剥夺背景的患者以及老年人更有可能在诊断时出现晚期肿瘤。(C)2017爱思唯尔有限公司版权所有
Introduction: Tumour staging at time of presentation is an important factor in determining survival in colorectal cancer. The aim of this paper is to investigate the relationship between ethnicity and deprivation in late (Stage IV) presentation of colorectal cancer.Methods: Data from the Thames Cancer Registry comprising 77,057 colorectal cancer patients between the years 2000 and 2012 were analysed.Results: A total of 17,348 patients were identified with complete data, of which 53.9% were male. Patients from a Black Afro/Caribbean background were diagnosed with CRC at a much younger age than the White British group (median age 67 compared with 72, p < 0.001). In multiple regression, ethnicity, deprivation and age were positive predictors of presenting with advanced tumour stage at time of diagnosis. Black patients were more likely to present with Stage IV tumours than white patients (OR 1.37, 95% CI 1.18-1.59, p < 0.001). Social deprivation was also a predictor of Stage IV cancer presentation, with the most deprived group (Quintile 5) 1.26 times more likely to be diagnosed with Stage IV cancer compared with the most affluent group (CI 1.13-1.40, p < 0.001). Sub-group analyses demonstrated that Black & Affluent patients were still at greater risk of Stage IV CRC than their White & Affluent counterparts (OR 1.24, 95% CI 1.111.45, p = 0.023). Patients with rectal cancer were less likely to present with Stage IV CRC (OR 0.66, 95% CI 0.61-0.71, p < 0.001).Conclusion: Racial and age related disparities exist in tumour presentation in the United Kingdom. Patients from black and socially deprived backgrounds as well as the elderly are more likely to present with advanced tumours at time of diagnosis. (C) 2017 Elsevier Ltd. All rights reserved.