Yu Xue Q, O'connell Dianne L, Gibberd Robert W, Armstrong Bruce K
Cancer Epidemiology Research Unit, The Cancer Council New South Wales, P.O. Box 572, Kings Cross, Sydney, NSW 2011, Australia.
Eur J Cancer. 2005 Nov;41(17):2715-21. doi: 10.1016/j.ejca.2005.05.018. Epub 2005 Oct 17.
In this study, we have investigated the impact of area of residence on survival from colon and rectal cancer. Relative survival and relative excess risk of death from cancer were calculated for each of 17 health areas in New South Wales, Australia. There were statistically significant differences in survival across areas for both cancers after adjusting for demographic factors. The variation remained for colon cancer but was reduced for rectal cancer after adjustment for spread of disease at diagnosis. This persistent variation in colon cancer survival suggests that variation in treatment contributes to it, and there is separate evidence for such variation. Of the 7186 patients whose deaths within five years were attributable to colorectal cancer, 784 could have had their survival increased to more than five years if the excess risk of death in all areas was reduced to the 20th centile of its distribution. Estimates such as this can assist in prioritizing improvements in cancer services.
在本研究中，我们调查了居住地区对结肠癌和直肠癌生存率的影响。我们计算了澳大利亚新南威尔士州17个健康区域中每个区域的相对生存率和癌症相对超额死亡风险。在调整人口统计学因素后，两种癌症在各区域的生存率存在统计学显著差异。调整诊断时疾病的扩散情况后，结肠癌的差异仍然存在，但直肠癌的差异有所减小。结肠癌生存率的这种持续差异表明治疗差异是导致其产生的原因，并且有单独的证据证明这种差异的存在。在5年内死于结直肠癌的7186名患者中，如果所有区域的超额死亡风险降低到其分布的第20百分位数，那么784人的生存期本可延长至5年以上。这样的估计有助于确定癌症服务改进的优先次序。
