Factors Associated with Colon Cancer Stage at Diagnosis
Factors Associated with Colon Cancer Stage at Diagnosis
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DOI：
10.1007/s10620-008-0669-0
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发表时间：
2009-12-01
影响因子：
3.1
通讯作者：
Ward, Elizabeth M.
中科院分区：
文献类型：
--
作者：
Halpern, Michael T.;Pavluck, Alexandre L.;Ward, Elizabeth M.
我们分析了国家癌症数据库 1998 年至 2004 年的数据，以评估患者/治疗设施因素与所有结肠癌的诊断分期和解剖位置之间的关联。与有私人保险的患者相比，未投保的患者更有可能出现晚期疾病；医疗补助患者患晚期结肠癌的可能性介于私人保险患者和未保险患者之间。在黑人（与白人相比）、女性（与男性相比）和来自低社会经济地位（SES）地区的患者（与来自较高SES地区的患者）中也观察到诊断时晚期结肠癌的几率增加。虽然在随后的几年中诊断时处于晚期疾病的可能性总体上有所下降，但在升结肠癌患者中并未观察到这种下降。筛查差异可能导致结肠癌患者诊断时处于更晚期；改善服务不足人群获得筛查机会的方案可能会解决这一差距。
We analyzed data from 1998-2004 from the National Cancer Data Base to evaluate associations between patient/treatment facility factors and stage at diagnosis for all colon cancers combined and by anatomic location. Compared to patients with private insurance, uninsured patients were significantly more likely to present with advanced-stage disease; Medicaid patients had likelihoods of advanced-stage colon cancer in-between those of privately insured and uninsured patients. Increased odds of advanced-stage colon cancer at diagnosis were also observed among Black (vs. White) patients, women (vs. men), and patients from low socioeconomic status (SES) regions (vs. those from higher SES regions). While the likelihood of advanced-stage disease at diagnosis decreased in later years overall, this decrease was not observed among patients with ascending colon cancers. Screening disparities may lead to more advanced stage at diagnosis among colon cancer patients; programs to improve access to screening among underserved populations may address this disparity.