Karjalainen S, Pukkala E
Finnish Cancer Registry, Helsinki.
Cancer. 1990 Aug 15;66(4):819-26. doi: 10.1002/1097-0142(19900815)66:4<819::aid-cncr2820660437>3.0.co;2-e.
The effect of social class on survival of female breast cancer patients was studied by linking the patient files of the Finnish Cancer Registry (FCR) with the information on patient's social status, obtained from the 1970 Population Census of Finland. The material consisted of 10,181 patients 25 to 69 years of age at diagnosis, whose cancer was diagnosed between 1971 and 1980. The classification of social class was based on occupation. The effects of social class, age, period of diagnosis, and stage of disease on survival were evaluated using the Cox proportional hazards model; mortality from causes of death other than breast cancer was taken into account using the exact causes of death. Those in the lowest social class had about 1.3 times higher relative excess risk of dying than those in the highest social class. The older the patients, the greater was the difference in survival by social class. Differences in stage distribution explained only a minor proportion of the variation in survival by social class. The Finnish legislation guarantees everyone fairly equal accessibility to health care. The results suggest that more determined efforts should be undertaken to reduce inequity in survival.
通过将芬兰癌症登记处（FCR）的患者档案与从1970年芬兰人口普查中获取的患者社会地位信息相联系，研究了社会阶层对女性乳腺癌患者生存的影响。该资料包括10181名诊断时年龄在25至69岁之间的患者，她们的癌症在1971年至1980年期间被诊断出来。社会阶层的分类基于职业。使用Cox比例风险模型评估社会阶层、年龄、诊断时期和疾病阶段对生存的影响；使用确切死因考虑除乳腺癌以外的其他死因导致的死亡率。社会阶层最低的人群死亡的相对超额风险比社会阶层最高的人群高约1.3倍。患者年龄越大，社会阶层对生存的差异就越大。阶段分布的差异仅解释了社会阶层生存差异的一小部分。芬兰法律保障每个人享有相当平等的医疗保健机会。结果表明，应更加坚定地努力减少生存方面的不平等。
