Schillinger J A, Grosclaude P C, Honjo S, Quinn M J, Sloggett A, Coleman M P
The Division of Sexually Transmitted Diseases Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Mailstop E-02, Atlanta, GA 30333, USA.
Arch Dis Child. 1999 Apr;80(4):311-7. doi: 10.1136/adc.80.4.311.
National cancer registry data, linked to an areal measure of material deprivation, were used to explore possible socioeconomic and regional variation in the survival of children (0-14 years) diagnosed with acute lymphocytic leukaemia (ALL) in England and Wales from 1971 to 1990. Survival analysis and Poisson regression were used to estimate observed (crude) survival probabilities and the adjusted hazard of death. There was little evidence of a socioeconomic gradient in survival. Regional differences in survival were observed over time. These differences were most pronounced in the first six months after diagnosis, and may be attributable to differential access to centralised paediatric oncology services or treatment protocols, or to the artefact of variations in regional cancer registry practice. Similar analyses should be repeated for other, less treatable childhood cancers. The results of this study can be used to help identify ways of reducing regional variation in survival.
利用与物质匮乏的区域衡量指标相关联的国家癌症登记数据，探究1971年至1990年期间在英格兰和威尔士被诊断患有急性淋巴细胞白血病（ALL）的0至14岁儿童生存情况可能存在的社会经济和区域差异。采用生存分析和泊松回归来估计观察到的（粗）生存概率和调整后的死亡风险。几乎没有证据表明生存存在社会经济梯度。随着时间推移观察到了生存的区域差异。这些差异在诊断后的头六个月最为明显，可能归因于获得集中式儿科肿瘤服务或治疗方案的差异，或者区域癌症登记实践差异这一假象。对于其他较难治疗的儿童癌症，应重复进行类似分析。本研究结果可用于帮助确定减少生存区域差异的方法。
