Syriopoulou Elisavet, Bower Hannah, Andersson Therese M-L, Lambert Paul C, Rutherford Mark J
Biostatistics Research Group, Department of Health Sciences, University of Leicester, Centre for Medicine, University Road, Leicester LE1 7RH, UK.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
Br J Cancer. 2017 Oct 24;117(9):1419-1426. doi: 10.1038/bjc.2017.300. Epub 2017 Sep 12.
Differences in cancer survival exist across socio-economic groups for many cancer types. Standard metrics fail to show the overall impact for patients and the population.
The available data consist of a population of ∼2.5 million patients and include all patients recorded as being diagnosed with melanoma, prostate, bladder, breast, colon, rectum, lung, ovarian and stomach cancers in England between 1998 and 2013. We estimated the average loss in expectation of life per patient in years and the proportion of life lost for a range of cancer types, separately by deprivation group. In addition, estimates for the total number of years lost due to each cancer were also obtained.
Lung and stomach cancers result in the highest overall loss for males and females in all deprivation groups in terms of both absolute life years lost and loss as a proportion of expected life remaining. Female lung cancer patients in the least- and most-deprived group lose 14.4 and 13.8 years on average, respectively, that is translated as 86.1% and 87.3% of their average expected life years remaining. Melanoma, prostate and breast cancers have the lowest overall loss. On the basis of the number of patients diagnosed in 2013, lung cancer results in the most life years lost in total followed by breast cancer. Melanoma and bladder cancer account for the lowest total life years lost.
There are wide differences in the impact of cancer on life expectancy across deprivation groups, and for most cancers the most affluent lose less years.
对于多种癌症类型，社会经济群体之间的癌症生存率存在差异。标准指标未能显示出对患者和人群的总体影响。
现有数据包括约250万患者，涵盖1998年至2013年期间在英格兰被记录诊断为黑色素瘤、前列腺癌、膀胱癌、乳腺癌、结肠癌、直肠癌、肺癌、卵巢癌和胃癌的所有患者。我们分别按贫困程度组估算了每种癌症类型每位患者预期寿命的平均损失年数以及生命损失比例。此外，还获得了每种癌症导致的总损失年数估计值。
就绝对生命损失年数以及作为剩余预期寿命的比例损失而言，肺癌和胃癌在所有贫困程度组中导致男性和女性的总体损失最高。最贫困和最富裕组的女性肺癌患者平均分别损失14.4年和13.8年，这相当于她们剩余平均预期寿命的86.1%和87.3%。黑色素瘤、前列腺癌和乳腺癌的总体损失最低。根据2013年诊断出的患者数量，肺癌导致的总生命损失年数最多，其次是乳腺癌。黑色素瘤和膀胱癌导致的总生命损失年数最低。
不同贫困程度组中癌症对预期寿命的影响存在很大差异，对于大多数癌症而言，最富裕人群损失的年数较少。
