社会经济地位与确诊时的卵巢癌分期：一项嵌套于英国卵巢癌筛查协作试验中的研究
Socioeconomic Status and Ovarian Cancer Stage at Diagnosis: A Study Nested Within UKCTOCS.
作者信息
Karpinskyj Chloe, Burnell Matthew, Gonzalez-Izquierdo Arturo, Ryan Andy, Kalsi Jatinderpal, Jacobs Ian, Parmar Max, Menon Usha, Gentry-Maharaj Aleksandra
机构信息
MRC CTU at UCL, Institute of Clinical Trials and Methodology, University College London, 90 High Holborn, London WC1V 6LJ, UK.
Institute of Health Informatics, University College London, 222 Euston Road, London NW1 2DA, UK.
出版信息
Diagnostics (Basel). 2020 Feb 7;10(2):89. doi: 10.3390/diagnostics10020089.
BACKGROUND
Tubo-ovarian cancer (OC) continues to be the most lethal of all gynaecological cancers. Over half of women are diagnosed with late stage (III/IV) disease, which has a five-year survival rate of 11%. Socioeconomic status (SES) has been shown to have an impact on outcomes of several cancer types, including OC. This study aims to investigate any potential association between SES and stage at diagnosis of OC.
METHODS
Women from the non-screening arm of the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) with a confirmed diagnosis of OC prior to 01 January 2015 and an English index of multiple deprivation (IMD) score were eligible for the study. The association between IMD and OC stage (FIGO) was analysed using an ordinal logistic regression model adjusted for age at diagnosis and BMI.
RESULTS
Four-hundred and fifty seven women were eligible for inclusion in the primary analysis. The odds of being diagnosed with the higher dichotomization of stage (I vs. II/III/IV; I/II vs. III/IV; I/II/III vs. IV) was 1.29 (p = 0.017; 95% CI: 1.048-1.592) per unit SD (standard deviation) increase in IMD. This translates to a 29% increase in odds of being diagnosed at the higher stage per each unit SD increase in IMD.
CONCLUSION
Increased deprivation is consistently associated with a higher probability of being diagnosed with later stage OC.
背景
输卵管卵巢癌（OC）仍然是所有妇科癌症中致死率最高的。超过半数的女性被诊断为晚期（III/IV期）疾病，其五年生存率为11%。社会经济地位（SES）已被证明会对包括OC在内的几种癌症类型的预后产生影响。本研究旨在调查SES与OC诊断分期之间的任何潜在关联。
方法
来自英国卵巢癌筛查协作试验（UKCTOCS）非筛查组的女性，在2015年1月1日前确诊为OC且有英国多重剥夺指数（IMD）评分，符合本研究条件。使用经诊断年龄和体重指数调整的有序逻辑回归模型分析IMD与OC分期（FIGO）之间的关联。
结果
457名女性符合纳入初步分析的条件。IMD每增加一个单位标准差（SD），被诊断为更高分期二分法（I期与II/III/IV期；I/II期与III/IV期；I/II/III期与IV期）的几率为1.29（p = 0.017；95% CI：1.048 - 1.592）。这意味着IMD每增加一个单位标准差，被诊断为更高分期的几率增加29%。
结论
贫困程度增加始终与晚期OC诊断概率较高相关。
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