Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge, Cambridge, UK.
Ann Oncol. 2013 Mar;24(3):843-50. doi: 10.1093/annonc/mds526. Epub 2012 Nov 12.
Understanding socio-demographic inequalities in stage at diagnosis can inform priorities for cancer control.
We analysed data on the stage at diagnosis of East of England patients diagnosed with any of 10 common cancers, 2006-2010. Stage information was available on 88 657 of 98 942 tumours (89.6%).
Substantial socio-demographic inequalities in advanced stage at diagnosis (i.e. stage III/IV) existed for seven cancers, but their magnitude and direction varied greatly by cancer: advanced stage at diagnosis was more likely for older patients with melanoma but less likely for older patients with lung cancer [odds ratios for 75-79 versus 65-69 1.60 (1.38-1.86) and 0.83 (0.77-0.89), respectively]. Deprived patients were more likely to be diagnosed in advanced stage for melanoma, prostate, endometrial and (female) breast cancer: odds ratios (most versus least deprived quintile) from 2.24 (1.66-3.03) for melanoma to 1.31 (1.15-1.49) for breast cancer. In England, elimination of socio-demographic inequalities in stage at diagnosis could decrease the number of patients with cancer diagnosed in advanced stage by ∼5600 annually.
There are substantial socio-demographic inequalities in stage at diagnosis for most cancers. Earlier detection interventions and policies can be targeted on patients at higher risk of advanced stage diagnosis.
了解诊断时社会人口学不平等现象可以为癌症控制提供优先事项。
我们分析了 2006 年至 2010 年期间，英国东部地区诊断出的 10 种常见癌症患者的诊断时分期数据。88657 例/98942 例肿瘤（89.6%）中可获得分期信息。
7 种癌症的诊断时晚期（即 III/IV 期）存在显著的社会人口学不平等现象，但程度和方向因癌症而异：黑色素瘤的老年患者更有可能处于晚期，而肺癌的老年患者则不太可能处于晚期[75-79 岁与 65-69 岁患者的比值比为 1.60（1.38-1.86）和 0.83（0.77-0.89）]。贫困患者更有可能因黑色素瘤、前列腺癌、子宫内膜癌和（女性）乳腺癌而被诊断为晚期：比值比（最贫困与最不贫困五分之一）从黑色素瘤的 2.24（1.66-3.03）到乳腺癌的 1.31（1.15-1.49）。在英格兰，消除诊断时的社会人口学不平等现象，每年可使约 5600 名癌症患者被诊断为晚期。
大多数癌症的诊断时分期存在显著的社会人口学不平等现象。可以针对处于晚期诊断风险较高的患者开展早期检测干预和政策。
