Engberg Henriette, Steding-Jessen Marianne, Øster Inge, Jensen Jens Winther, Fristrup Claus Wilki, Møller Henrik
Dan Med J. 2020 Feb;67(2).
Pancreatic cancer is among the most lethal malignancies with a five-year survival of about 5%, and the only curative treatment is surgical resection. Denmark consists of five governmental regions and has four surgical centres. Our aim was to explore the regional and socio-economic differences in overall survival following a pancreatic cancer diagnosis in Denmark.
We included a total of 5,244 pancreatic cancer patients (WHO International Classification of Diseases, tenth version C25) registered in the Danish Pancreatic Cancer Database during 2012-2017. The data sources used were the Danish Civil Registration System, the Danish National Patient Registry and the Danish national registers on education and income at Statistics Denmark. Cox regression analysis was used to examine all-cause mortality of pancreatic cancer patients by region of residence and socio-economic status.
Compared to The Capital Region, there was an excess mortality in the Central Denmark Region and the North Denmark Region in both men and women, whereas no increased mortality was observed in the Region of Southern Denmark or in Region Zealand. Estimates were adjusted for age, year of diagnosis and comorbidity. Adjustment for surgical resection greatly attenuated the variation in survival between the regions.
We found significant differences in overall survival across the five Danish regions following a diagnosis of pancreatic cancer. The regional variation in survival was largely attributable to differences in the propensity to use surgical resection.
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胰腺癌是最致命的恶性肿瘤之一，五年生存率约为5%，唯一的治愈性治疗方法是手术切除。丹麦由五个政府区域组成，有四个手术中心。我们的目的是探讨丹麦胰腺癌诊断后总体生存率的区域和社会经济差异。
我们纳入了2012年至2017年期间在丹麦胰腺癌数据库中登记的总共5244例胰腺癌患者（世界卫生组织国际疾病分类第十版C25）。使用的数据来源是丹麦民事登记系统、丹麦国家患者登记处以及丹麦统计局关于教育和收入的国家登记处。采用Cox回归分析按居住地区和社会经济状况检查胰腺癌患者的全因死亡率。
与首都地区相比，丹麦中部地区和北丹麦地区的男性和女性死亡率均较高，而南丹麦地区或西兰岛地区未观察到死亡率增加。估计值根据年龄、诊断年份和合并症进行了调整。对手术切除进行调整大大减弱了各地区之间生存率的差异。
我们发现丹麦五个地区在胰腺癌诊断后的总体生存率存在显著差异。生存的区域差异很大程度上归因于手术切除倾向的差异。
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