Gregorio David I, Huang Lan, DeChello Laurie M, Samociuk Holly, Kulldorff Martin
Department of Community Medicine & Health Care, University of Connecticut School of Medicine, Farmington, CT 06030-6205, USA.
Ann Epidemiol. 2007 Jul;17(7):520-4. doi: 10.1016/j.annepidem.2006.12.003. Epub 2007 Apr 19.
To examine geographic variation in survival time of men diagnosed with prostate cancer, adjusted for patient and disease characteristics.
Survival times for a geographically referenced database of 27,189 incident prostate cancer cases (ICD-O-2: C61.9) from Connecticut, 1984-1998, were evaluated using a newly developed extension of the spatial scan statistic for survival data.
Statewide, median survival time was 4.6 years following diagnosis. Age-adjusted survival times across most locales around Connecticut did not differ markedly from the statewide pattern, but our analysis revealed 3 zones with noteworthy differences. Analysis of survival times adjusted for age as well as tumor grade and stage produced only two locations with significant results, and further adjustment for racial composition of cases yielded only one location with significant distinct (lower) survival times. Among cases within that place, the likelihood of dying was estimated to be 1.39-times greater than that of cases different from those diagnosed elsewhere around the state (p = 0.009).
The prognosis for men with prostate cancer may differ, in part, by virtue of where they live when diagnosed. Measuring geographic differences in survival time should facilitate the targeting of clinical and ancillary services to persons at high risk of poor outcomes.
在对患者和疾病特征进行调整后，研究被诊断为前列腺癌的男性患者生存时间的地理差异。
使用一种新开发的针对生存数据的空间扫描统计量扩展方法，对1984 - 1998年来自康涅狄格州的27189例前列腺癌新发病例（ICD - O - 2：C61.9）的地理参考数据库的生存时间进行评估。
在全州范围内，诊断后的中位生存时间为4.6年。康涅狄格州周边大多数地区经年龄调整后的生存时间与全州模式没有显著差异，但我们的分析发现了3个有显著差异的区域。对年龄以及肿瘤分级和分期进行调整后的生存时间分析仅产生了2个有显著结果的地点，对病例种族构成进行进一步调整后仅产生了1个生存时间有显著差异（更低）的地点。在该地区的病例中，估计死亡可能性比该州其他地区诊断的病例高1.39倍（p = 0.009）。
前列腺癌男性患者的预后可能部分因诊断时居住地点的不同而有所差异。测量生存时间的地理差异应有助于将临床和辅助服务针对预后不良高风险人群。
