Niu Xiaoling, Pawlish Karen S, Roche Lisa M
Epidemiology Services, New Jersey Department of Health and Senior Services, NJ, USA.
J Health Care Poor Underserved. 2010 Feb;21(1):144-60. doi: 10.1353/hpu.0.0263.
We investigated racial/ethnic and socioeconomic disparities in cancer survival and assessed if racial disparities can be explained by socioeconomic status (SES) using New Jersey State Cancer Registry data. We included cancer cases diagnosed during 1986-1999 (n=471,939). Hazard ratios were calculated for all cancers combined and female breast, colorectal, lung, and prostate cancers by race/ethnicity and SES for cases diagnosed in 1993-1999. Survival rates were compared for diagnosis years 1986-1992 and 1993-1999. We observed worse survival in Black patients and a SES gradient in the risk of cancer death after adjusting for age and stage at diagnosis. Following adjustment by SES, the higher risks of cancer death for Blacks were attenuated for breast, colorectal, and prostate cancer and became non-significant for lung cancer. Racial/ethnic disparities in cancer survival can be partially explained by SES. Cancer survival rates improved significantly from 1986-1992 to 1993-1999 except for women in the poorest areas.
我们利用新泽西州癌症登记处的数据,调查了癌症生存率方面的种族/民族和社会经济差异,并评估了种族差异是否可以用社会经济地位(SES)来解释。我们纳入了1986年至1999年期间诊断出的癌症病例(n = 471,939)。针对1993年至1999年诊断出的病例,按种族/民族和社会经济地位计算了所有癌症合并以及女性乳腺癌、结直肠癌、肺癌和前列腺癌的风险比。比较了1986年至1992年和1993年至1999年诊断年份的生存率。在调整了诊断时的年龄和分期后,我们观察到黑人患者的生存率较差,且癌症死亡风险存在社会经济地位梯度。在按社会经济地位进行调整后,黑人在乳腺癌、结直肠癌和前列腺癌方面较高的癌症死亡风险有所降低,在肺癌方面则变得不显著。癌症生存率方面的种族/民族差异可以部分用社会经济地位来解释。除了最贫困地区的女性外,1986年至1992年到1993年至1999年期间癌症生存率有显著提高。