Whynes D K, Frew E J, Manghan C M, Scholefield J H, Hardcastle J D
School of Economics, University of Nottingham, Nottingham NG7 2RD, UK.
Public Health. 2003 Nov;117(6):389-95. doi: 10.1016/S0033-3506(03)00146-X.
To determine the extent to which socio-economic deprivation explains colorectal cancer prevalence, subject participation in screening, and postoperative survival and life expectancy.
Regression analyses of clinical data from a large randomized controlled trial, augmented by geographical-based indices of deprivation.
Deprivation appears to exert no significant impact on colorectal cancer prevalence but is a major factor explaining subject participation in screening. Cancer detection at later stages reduces life expectancy at time of treatment. Females from more-deprived areas have poorer post-treatment life expectancies and survival prospects, independently of their screening behaviour.
Screening increases the chances of having a cancer treated at an earlier stage, and treatment at an earlier stage is associated with longer subsequent life expectancy. However, those from more-deprived areas are less likely to accept an invitation to be screened.
确定社会经济剥夺在多大程度上解释了结直肠癌的患病率、受试者参与筛查的情况、术后生存率和预期寿命。
对一项大型随机对照试验的临床数据进行回归分析,并辅以基于地理区域的剥夺指数。
剥夺似乎对结直肠癌患病率没有显著影响,但却是解释受试者参与筛查的一个主要因素。晚期癌症检测会降低治疗时的预期寿命。来自贫困地区的女性,无论其筛查行为如何,治疗后的预期寿命和生存前景都较差。
筛查增加了早期治疗癌症的机会,而早期治疗与更长的后续预期寿命相关。然而,来自贫困地区的人接受筛查邀请的可能性较小。