Davoudi-Monfared Esmat, Heidarnia Mohammad Ali, Akbari Mohammad Esmail, Yavari Parvin, Abadi Alireza
Dept. of Community Medicine and Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Iran J Cancer Prev. 2012 Fall;5(4):203-9.
Cancer is the second cause of death in the world, and colon cancer is the third cause of death and is one of the most common cancers which will cure with early diagnosis, treatment and sufficient follow up. Assessing factors which affect this cancer is important for prolonging patient survival. Socioeconomic factors are among effective factors of cancer morbidity and mortality. Because mortality rates for colon cancers vary by socioeconomic characteristics, this study has been performed to recognize the relationship between socioeconomic factors with treatment and follow up of colon cancer.
This was a cross-sectional, descriptive study for patients with colon cancer registered in Cancer Research Center of Shahid Beheshti University of Medical Sciences from April 2005 to November 2006. Patients were selected randomly, and the study was conducted using questionnaires filled by interviewing the patients via phone (if a patient was dead, the questions were asked from their family members). Data analysis was done using SPSS (version 19) software.
The study was performed on 520 colon cancer patients with age range of 23-88 years. The mean age of the patients was 63 (S.D.=11.8) and the median age was 64. Two hundred thirty seven (45.4%) patients were female and 283 (54.4%) were male. Using Chi-square test, age<60 (p=0.002) and female gender (p=0.034) had a significant correlation with complete treatment and there was a significant relationship between complete follow up and age<60 (p=0.037), academic education (p=0.02) and having insurance (p=0.021). Multiple logistic regression tests were used to evaluate concurrent effects of variables on treatment and follow up. Correlated variables to complete treatment include: age<60 (p=0.001), and female gender The Odds Ratio (OR) of completing treatment for patients under 60 years of age versus patients above 60 years was 3.13 (95% C.I. 1.55 to 6.34), and the OR of completing treatment for women versus men was 1.91(95% C.I. 1.33 to 2.74). Correlated variables to follow up were academic education ( ) and having insurance . The OR of cancer follow up in illiterate patients versus college-educated patients was 0.45 (95% C.I. 0.24 to 0.82), and the OR of cancer follow up in patients without insurance versus patients with health was 0.46 (95% C.I. 0.21 to 0.98).
Age is a correlated factor on completing colon cancer treatment. Women have more complete colon cancer treatment than men. Academic education and having insurance were the most important factors among socioeconomic factors observed in a five-year follow up after treatment. As the population of the old is increasing, executing effective interventions to improve treatment and follow up procedures for old patients is of prime importance. It seems that increasing the insurance contribution in follow up measures may lead to increase in the regular follow up and may affect patients' survival.
癌症是全球第二大致死原因，结肠癌是第三大致死原因，也是最常见的癌症之一，早期诊断、治疗及充分的随访可实现治愈。评估影响该癌症的因素对于延长患者生存期至关重要。社会经济因素是癌症发病率和死亡率的有效影响因素之一。由于结肠癌死亡率因社会经济特征而异，本研究旨在确定社会经济因素与结肠癌治疗及随访之间的关系。
这是一项横断面描述性研究，研究对象为2005年4月至2006年11月在沙希德·贝赫什提医科大学癌症研究中心登记的结肠癌患者。患者随机选取，通过电话访谈患者（若患者已去世，则向其家属提问）填写问卷的方式开展研究。使用SPSS（版本19）软件进行数据分析。
本研究共纳入520例结肠癌患者，年龄范围为23 - 88岁。患者平均年龄为63岁（标准差=11.8），中位年龄为64岁。237例（45.4%）患者为女性，283例（54.4%）为男性。采用卡方检验，年龄<60岁（p = 0.002）和女性性别（p = 0.034）与完整治疗显著相关，完整随访与年龄<60岁（p = 0.037）、接受过学术教育（p = 0.02）及拥有保险（p = 0.021）之间存在显著关系。采用多元逻辑回归检验评估变量对治疗和随访的综合影响。与完整治疗相关的变量包括：年龄<60岁（p = 0.001）和女性性别。60岁以下患者与60岁以上患者完成治疗的比值比（OR）为3.13（95%置信区间1.55至6.34），女性与男性完成治疗的OR为1.91（95%置信区间1.33至2.74）。与随访相关的变量为接受过学术教育和拥有保险。文盲患者与受过大学教育患者癌症随访的OR为0.45（95%置信区间0.24至0.82），无保险患者与有医疗保险患者癌症随访的OR为0.46（95%置信区间0.21至0.98）。
年龄是影响结肠癌治疗完成情况的相关因素。女性的结肠癌治疗比男性更完整。在治疗后的五年随访中，接受过学术教育和拥有保险是观察到的社会经济因素中最重要的因素。随着老年人口的增加，实施有效的干预措施以改善老年患者的治疗和随访程序至关重要。似乎增加随访措施中的保险投入可能会导致定期随访增加，并可能影响患者的生存。
