Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.
Epidemiol Health. 2013 Jun 20;35:e2013004. doi: 10.4178/epih/e2013004. Print 2013.
We aimed to investigate factors associated with colorectal cancer survival in Golestan, Iran.
We used a population based cancer registry to recruit study subjects. All patients registered since 2004 were contacted and data were collected using structured questionnaires and trained interviewers. All the existing evidences to determine the stage of the cancer were also collected. The time from first diagnosis to death was compared in patients according to their stage of cancer using the Kaplan-Meir method. A Cox proportional hazard model was built to examine their survival experience by taking into account other covariates.
Out of a total of 345 subjects, 227 were traced. Median age of the subjects was 54 and more than 42% were under 50 years old. We found 132 deaths among these patients, 5 of which were non-colorectal related deaths. The median survival time for the entire cohort was 3.56 years. A borderline significant difference in survival experience was detected for ethnicity (log rank test, p=0.053). Using Cox proportional hazard modeling, only cancer stage remained significantly associated with time of death in the final model.
Colorectal cancer occurs at a younger age among people living in Golestan province. A very young age at presentation and what appears to be a high proportion of patients presenting with late stage in this area suggest this population might benefit substantially from early diagnoses by introducing age adapted screening programs.
我们旨在研究与伊朗戈勒斯坦地区结直肠癌生存相关的因素。
我们使用基于人群的癌症登记处招募研究对象。自 2004 年以来登记的所有患者均被联系，并使用结构化问卷和经过培训的访谈员收集数据。还收集了所有现有证据来确定癌症的分期。根据癌症分期，使用 Kaplan-Meier 方法比较患者的首次诊断至死亡时间。建立 Cox 比例风险模型，考虑其他协变量，检查他们的生存情况。
在总共 345 名受试者中，有 227 名被追踪。受试者的中位年龄为 54 岁，超过 42%的人年龄在 50 岁以下。在这些患者中，我们发现了 132 例死亡，其中 5 例与结直肠癌无关。整个队列的中位生存时间为 3.56 年。生存经验的种族差异具有统计学意义（对数秩检验，p=0.053）。使用 Cox 比例风险建模，只有癌症分期在最终模型中与死亡时间显著相关。
居住在戈勒斯坦省的人们患结直肠癌的年龄较小。在该地区，患者呈现非常年轻的发病年龄，且似乎有很大比例的患者呈现晚期，这表明该人群可能通过引入适合年龄的筛查计划，从早期诊断中大大受益。
