Social factors, treatment, and survival in early-stage non-small cell lung cancer
Social factors, treatment, and survival in early-stage non-small cell lung cancer
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DOI：
10.2105/ajph.88.11.1681
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发表时间：
1998-11-01
影响因子：
12.7
通讯作者：
Goodman, G
中科院分区：
文献类型：
--
作者：
Greenwald, HP;Polissar, NL;Goodman, G
目标.本研究评估了社会经济地位、种族和接受手术的可能性在解释I期非小细胞肺癌患者死亡率方面的重要性。分析集中于1980年至1982年在底特律、弗朗西斯科和西雅图诊断为I期非小细胞肺癌的75岁及以下黑人和白色个体（n=5189）。主要的预后指标是诊断后的生存月数。收入最高十分位的患者接受手术治疗的可能性比收入最低十分位的患者高45%，5年生存率高102%。白人接受手术的可能性比黑人高20%，5年生存率高31%。控制年龄和性别的多变量程序证实了这些观察结果。社会经济地位和种族似乎独立影响生存的可能性。不接受手术可以解释死亡率过高的原因。
Objectives. This study assessed the importance of socioeconomic status, race, and likelihood of receiving surgery in explaining mortality among patients with stage-I non-small cell lung cancer.Methods. Analyses focused on Black and White individuals 75 years of age and younger (n=5189) diagnosed between 1980 and 1982 with stage-I non-small cell lung cancer in Detroit, San Francisco, and Seattle. The main outcome measure was months of survival after diagnosis.Results. Patients in the highest income decile were 45% more likely to receive surgical treatment and 102% more likely to attain 5-year survival than those in the lowest decile. Whites were 20% more likely to undergo surgery than Blacks and 31% more likely to survive 5 years. Multivariate procedures controlling for age and sex confirmed these observations.Conclusions. Socioeconomic status and race appear to independently influence likelihood of survival. Failure to receive surgery explains much excess mortality.