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与乳腺癌女性接受对侧预防性乳房切除术相关的社会经济因素。

Socioeconomic Factors Associated with the Receipt of Contralateral Prophylactic Mastectomy in Women with Breast Cancer.

机构信息

School of Nursing-Camden, Rutgers University, Camden, New Jersey.

Department of Health Informatics & Administration, University of Wisconsin, Madison, Wisconsin.

出版信息

J Womens Health (Larchmt). 2020 Feb;29(2):220-229. doi: 10.1089/jwh.2018.7350. Epub 2019 Feb 13.

Abstract

Contralateral prophylactic mastectomy (CPM) treatments have been on the rise among white women with early stage unilateral breast cancer who have a higher socioeconomic status (SES) and private insurance. Low income and uninsured women are not choosing CPM at the same rate. The purpose of this study was to evaluate the socioeconomic factors related to the choice of surgical treatment in women diagnosed with unilateral breast cancer in the state of New Jersey. This retrospective study of 10 years of breast cancer data abstracted from the New Jersey State Cancer Registry utilized bivariate analyses and two multivariate logistic regression models to analyze the effect of socioeconomics on choice of surgical treatment. In New Jersey, 52,529 women were treated for breast cancer from 2004 to 2014. CPM rates increased gradually over time from 3.72% in 2004 to 10.82% in 2014 with women more likely to choose CPM if they were younger, white, and had private insurance ( < 0.001). The single factor that was most predictive of choosing CPM was access to immediate reconstruction (odds ratio 2.36, confidence interval 2.160-2.551). Women with low SES were much less likely to choose CPM. Results of this study may provide incentive for researchers to assess the impact of culture, race/ethnicity, and socioeconomics on a woman's interactions with health care providers so as to allow all women regardless of SES to express their needs, concerns, and wishes when confronted with a breast cancer diagnosis.

摘要

对患有单侧乳腺癌且社会经济地位(SES)较高、拥有私人保险的白人女性而言,其接受预防性对侧乳房切除术(CPM)治疗的比例呈上升趋势。而低收入和无保险的女性选择 CPM 的比例则并不相同。本研究旨在评估新泽西州诊断为单侧乳腺癌的女性选择手术治疗的相关社会经济因素。

本研究对新泽西州癌症登记处的 10 年乳腺癌数据进行了回顾性研究,采用双变量分析和两种多变量逻辑回归模型,分析了社会经济因素对手术治疗选择的影响。2004 年至 2014 年,新泽西州共有 52529 名女性接受了乳腺癌治疗。CPM 率随时间逐渐增加,从 2004 年的 3.72%增至 2014 年的 10.82%,年轻、白人、拥有私人保险的女性更倾向于选择 CPM( < 0.001)。选择 CPM 的单一最具预测性因素是立即接受重建(优势比 2.36,置信区间 2.160-2.551)。社会经济地位较低的女性选择 CPM 的可能性较小。本研究的结果可能为研究人员提供动力,以评估文化、种族/民族和社会经济因素对女性与医疗保健提供者互动的影响,从而使所有女性无论 SES 如何,在面对乳腺癌诊断时都能表达自己的需求、担忧和愿望。

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