University of Groningen and University Medical Centre Groningen, Department of Medical Oncology, P.O. Box 30001, 9700 RB, Groningen, The Netherlands.
Br J Cancer. 2011 Mar 29;104(7):1193-5. doi: 10.1038/bjc.2011.64. Epub 2011 Feb 22.
Isolated groups, such as first generation non-Western immigrants, are at risk for suboptimal utilisation of the health care system resulting in a worse outcome.
From 1989 to 2007, all patients with stomach cancer were selected from the Comprehensive Cancer Centre North-East cancer registry. Associations between country of birth and patient, tumour and treatment characteristics were determined using χ(2) analysis. Relative survival analysis was used to estimate relative excess risk of dying according to country of birth (non-Western vs Western).
After adjusting for confounding factors (patient, tumour and treatment related), the risk of dying was lower for first generation non-Western immigrants (relative excess risk 0.55, 95% confidence interval 0.43-0.70) compared with Western patients.
Although the better survival of first generation non-Western immigrants with stomach cancer remains unexplained, it argues against accessibility problems within the Dutch health care system.
孤立群体，如第一代非西方移民，面临着医疗保健系统利用不足的风险，从而导致更糟糕的结果。
从 1989 年到 2007 年，所有胃癌患者均从东北地区综合癌症中心癌症登记处中选择。使用 χ(2)分析确定出生地与患者、肿瘤和治疗特征之间的关联。相对生存分析用于根据出生地（非西方与西方）估计死亡的相对超额风险。
在调整混杂因素（患者、肿瘤和治疗相关因素）后，第一代非西方移民的死亡风险较低（相对超额风险 0.55，95%置信区间 0.43-0.70），与西方患者相比。
尽管第一代非西方移民的胃癌生存情况更好，但这并不能说明荷兰医疗保健系统存在可及性问题。
