Weir Hannah K, Li Chunyu, Henley S Jane, Joseph Djenaba
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
Cancer Epidemiol Biomarkers Prev. 2017 May;26(5):736-742. doi: 10.1158/1055-9965.EPI-16-0702. Epub 2016 Dec 21.
Educational attainment (EA) is inversely associated with colorectal cancer risk. Colorectal cancer screening can save lives if precancerous polyps or early cancers are found and successfully treated. This study aims to estimate the potential productivity loss (PPL) and associated avoidable colorectal cancer-related deaths among screen-eligible adults residing in lower EA counties in the United States. Mortality and population data were used to examine colorectal cancer deaths (2008-2012) among adults aged 50 to 74 years in lower EA counties, and to estimate the expected number of deaths using the mortality experience from high EA counties. Excess deaths (observed-expected) were used to estimate potential years life lost, and the human capital method was used to estimate PPL in 2012 U.S. dollars. County-level colorectal cancer death rates were inversely associated with county-level EA. Of the 100,857 colorectal cancer deaths in lower EA counties, we estimated that more than 21,000 (1 in 5) was potentially avoidable and resulted in nearly $2 billion annual productivity loss. County-level EA disparities contribute to a large number of potentially avoidable colorectal cancer-related deaths. Increased prevention and improved screening potentially could decrease deaths and help reduce the associated economic burden in lower EA communities. Increased screening could further reduce deaths in all EA groups. These results estimate the large economic impact of potentially avoidable colorectal cancer-related deaths in economically disadvantaged communities, as measured by lower EA. .
教育程度(EA)与结直肠癌风险呈负相关。如果能发现并成功治疗癌前息肉或早期癌症,结直肠癌筛查可以挽救生命。本研究旨在估计居住在美国教育程度较低县的符合筛查条件的成年人中的潜在生产力损失(PPL)以及相关的可避免的结直肠癌相关死亡人数。死亡率和人口数据用于检查教育程度较低县中50至74岁成年人的结直肠癌死亡情况(2008 - 2012年),并使用教育程度较高县的死亡率经验来估计预期死亡人数。超额死亡人数(观察值 - 预期值)用于估计潜在寿命损失年数,人力资本法用于以2012年美元估计PPL。县级结直肠癌死亡率与县级教育程度呈负相关。在教育程度较低的县的100,857例结直肠癌死亡病例中,我们估计超过21,000例(五分之一)可能是可避免的,并且导致每年近20亿美元的生产力损失。县级教育程度差异导致大量潜在可避免的结直肠癌相关死亡。加强预防和改进筛查可能会减少死亡人数,并有助于减轻教育程度较低社区的相关经济负担。增加筛查可以进一步减少所有教育程度组中的死亡人数。这些结果估计了以教育程度较低衡量的经济弱势社区中潜在可避免的结直肠癌相关死亡带来的巨大经济影响。