Socioeconomic deprivation worsens the outcomes of Italian women with hormone receptor-positive breast cancer and decreases the possibility of receiving standard care.
Socioeconomic deprivation worsens the outcomes of Italian women with hormone receptor-positive breast cancer and decreases the possibility of receiving standard care.
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DOI：
10.18632/oncotarget.19447
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发表时间：
2017-09-15
期刊：
影响因子：
--
通讯作者：
Socioeconomic Inequalities and Oncological Outcomes Italian Working Group
中科院分区：
文献类型：
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作者：
Di Salvo F;Caranci N;Spadea T;Zengarini N;Minicozzi P;Amash H;Fusco M;Stracci F;Falcini F;Cirilli C;Candela G;Cusimano R;Tumino R;Sant M;Socioeconomic Inequalities and Oncological Outcomes Italian Working Group
社会经济因素影响获得癌症护理和生存的机会。这项研究通过患者的年龄和激素受体状态，调查了社会经济状况对乳腺癌复发风险和提供适当癌症护理(前哨淋巴结活检和保乳手术加放射治疗)的作用。2003-2005年确诊的3462例乳腺癌病例是从意大利的7个癌症登记处中挑选出来的，并根据其人口普查区域的贫困指数被分配到一个社会经济三分位数。多变量模型被用来评估前哨淋巴结活检和保乳手术加放射治疗在社会经济领域的提供情况。在1,893名年龄在65岁以下的女性中，最贫困组的5年复发风险高于最不贫困组，但这种差异并不显著(16.4%对12.9%，对数等级p=0.08)；65岁以下的女性≥没有发现差异。在2,024名患有激素受体阳性癌症的女性中，最贫困的人群的5年风险显著高于最不贫困的人群(13.0%比8.9%，p=0.04)；激素受体阴性的癌症患者的5年风险没有差异。与贫困程度最低的妇女相比，贫困程度最高的妇女接受前哨淋巴结活检(调整后的优势比(ORA)为0.69；95%可信区间(CI)为0.56~0.86)和接受保乳手术加放射治疗的可能性较低(ORA=0.66；95%可信区间为0.51~0.86)。结论：社会经济不平等影响荷尔蒙受体阳性癌症患者的复发风险和接受标准治疗的机会。
Socioeconomic factors influence access to cancer care and survival. This study investigated the role of socioeconomic status on the risk of breast cancer recurrence and on the delivery of appropriate cancer care (sentinel lymph node biopsy and breast-conserving surgery plus radiotherapy), by patients’ age and hormone receptor status. 3,462 breast cancer cases diagnosed in 2003-2005 were selected from 7 Italian cancer registries and assigned to a socioeconomic tertile on the basis of the deprivation index of their census tract. Multivariable models were applied to assess the delivery of sentinel lymph node biopsy and of breast-conserving surgery plus radiotherapy within socioeconomic tertiles. In the 1,893 women younger than 65 years, the 5-year risk of recurrence was higher in the most deprived group than in the least deprived, but this difference was not significant (16.4% vs. 12.9%, log-rank p=0.08); no difference was seen in women ≥65 years. Among the 2,024 women with hormone receptor-positive cancer, the 5-year risk was significantly higher in the most deprived group than in the least deprived one (13.0% vs. 8.9%, p=0.04); no difference was seen in cases of hormone receptor-negative cancer. The most deprived women were less likely than the least deprived women to receive sentinel lymph node biopsy (adjusted odds ratio (ORa), 0.69; 95% CI, 0.56-0.86) and to undergo breast-conserving surgery plus radiotherapy (ORa=0.66; 95% CI, 0.51-0.86). Conclusions: Socioeconomic inequalities affect the risk of recurrence, among patients with hormone receptor-positive cancer, and the opportunity to receive standard care.
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影响因子：
6.2
作者：
Gennari, R;Curigliano, G;Goldhirsch, A
通讯作者：
Goldhirsch, A
影响因子：
--
作者：
Moriceau, Guillaume;Bourmaud, Aurelie;Chauvin, Franck
通讯作者：
Chauvin, Franck
影响因子：
4.4
作者：
Pacelli, Barbara;Carretta, Elisa;Fantini, Maria P.
通讯作者：
Fantini, Maria P.
影响因子：
5.1
作者：
Ouedraogo, Samiratou;Dabakuyo-Yonli, Tienhan Sandrine;Arveux, Patrick
通讯作者：
Arveux, Patrick
影响因子：
2.3
作者：
Andaya, Abegail A.;Enewold, Lindsey;Zhu, Kangmin
通讯作者：
Zhu, Kangmin