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作为社会经济地位衡量指标的教育差异对乳腺癌患者生存的影响。

Impact of educational differences as measure of socioeconomic status on survival for breast cancer patients.

作者信息

Nowara Elżbieta, Suwiński Rafał

机构信息

Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice Branch, Poland.

出版信息

Contemp Oncol (Pozn). 2012;16(4):345-9. doi: 10.5114/wo.2012.30066. Epub 2012 Sep 29.

DOI:10.5114/wo.2012.30066
PMID:23788907
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3687433/
Abstract

AIM OF THE STUDY

Breast cancer is the most frequent malignancy affecting women. Some reports suggest the influence of socioeconomic status, including education, on survival rates for cancer patients. This report analyzes the effect of patients' education level on their survival.

MATERIAL AND METHODS

A retrospective analysis of the group of 810 breast cancer patients treated in single center in Poland was performed. The analyzed group included women with elementary education (24%), vocational training (19%), secondary (38%) or higher education (16%). Overall, recurrence-free and metastasis free survival times were analyzed.

RESULTS

The actuarial 5-year overall survival was 72% (median 4.7 years), 5-year local recurrence-free survival was 84%, whereas metastasis-free survival 76%. Multivariate Cox model has shown that lower education had independent significantly negative influence on local recurrence-free survival time (p = 0.024). The highest risk of recurrence was found for patients with elementary education (p = 0.009). The same was confirmed for distant metastasis-free survival (p = 0.001), with the highest risk of metastases in patients with vocational education and stage IIIB breast cancer (p < 0.001). Education level had significant impact on overall survival. The patients with higher-level education lived longer (p = 0.042).

CONCLUSIONS

Shorter recurrence-free survival time among women attaining lowest education level and longer overall survival time for women with higher education level suggest the necessity for intensified cancer awareness educational effort and screening among less-educated healthy Polish women.

摘要

研究目的

乳腺癌是影响女性的最常见恶性肿瘤。一些报告表明社会经济地位（包括教育程度）对癌症患者生存率有影响。本报告分析了患者教育水平对其生存的影响。

材料与方法

对波兰单一中心治疗的810例乳腺癌患者进行回顾性分析。分析组包括接受小学教育（24%）、职业培训（19%）、中等教育（38%）或高等教育（16%）的女性。总体上，分析了无复发生存期和无转移生存期。

结果

精算5年总生存率为72%（中位生存期4.7年），5年局部无复发生存率为84%，无转移生存率为76%。多变量Cox模型显示，较低的教育水平对局部无复发生存期有独立的显著负面影响（p = 0.024）。小学教育程度的患者复发风险最高（p = 0.009）。远处无转移生存期也得到同样证实（p = 0.001），职业教育且处于IIIB期乳腺癌患者转移风险最高（p < 0.001）。教育水平对总生存有显著影响。高教育水平的患者生存期更长（p = 0.042）。

结论

教育水平最低的女性无复发生存期较短，而高教育水平女性总生存期较长，这表明有必要加强对受教育程度较低的波兰健康女性的癌症意识教育和筛查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8de/3687433/4ce3c92ea1e4/WO-16-19114-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8de/3687433/0153edb8e6ed/WO-16-19114-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8de/3687433/d5382114964b/WO-16-19114-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8de/3687433/3268fe110838/WO-16-19114-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8de/3687433/9c7df8b3d84f/WO-16-19114-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8de/3687433/4ce3c92ea1e4/WO-16-19114-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8de/3687433/0153edb8e6ed/WO-16-19114-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8de/3687433/d5382114964b/WO-16-19114-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8de/3687433/3268fe110838/WO-16-19114-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8de/3687433/9c7df8b3d84f/WO-16-19114-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8de/3687433/4ce3c92ea1e4/WO-16-19114-g005.jpg

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