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2002-2017 年巴西公共口腔卫生服务和社会经济指标对口腔癌住院和死亡频率的影响。

Influence of Public Oral Health Services and Socioeconomic Indicators on the Frequency of Hospitalization and Deaths due to Oral Cancer in Brazil, between 2002-2017.

机构信息

Graduate Program in Dentistry, Department of Clinic and Social Dentistry, Federal University of Paraíba, University City, João Pessoa-PB 58046-600, Brazil.

出版信息

Int J Environ Res Public Health. 2020 Dec 31;18(1):238. doi: 10.3390/ijerph18010238.

Abstract

: Oral cancer is a frequent neoplasm worldwide, and socioeconomic factors and access to health services may be associated with its risk. Aim: To analyze effect of socioeconomic variables and the influence of public oral health services availability on the frequency of new hospitalized cases and mortality of oral cancer in Brazil. : This observational study analyzed all Brazilian cities with at least one hospitalized case of oral cancer in the National Cancer Institute database (2002-2017). For each city were collected: population size, Municipal Human Development Index (MHDI), Gini Coefficient, oral health coverage in primary care, number of Dental Specialized Centers (DSC) and absolute frequency of deaths after one year of the first treatment. The risk ratio was determined by COX regression, and the effect of the predictor variables on the incidence of cases was verified by the Hazard Ratio measure. Poisson regression was used to determine factors associated with higher mortality frequency. : Cities above 50,000 inhabitants, with high or very high MHDI, more unequal (Gini > 0.4), with less oral health coverage in primary care (<50%) and without DSC had a greater accumulated risk of having 1 or more cases ( < 0.001). Higher frequency of deaths was also associated with higher population size, higher MHDI, higher Gini and lower oral health coverage in primary care ( < 0.001). : The number hospitalization and deaths due to oral cancer in Brazil was influenced by the cities' population size, the population's socioeconomic status and the availability of public dental services.

摘要

口腔癌是全球常见的肿瘤之一,社会经济因素和获得卫生服务的机会可能与其风险相关。目的:分析社会经济变量的影响以及公共口腔卫生服务的可及性对巴西新住院病例和口腔癌死亡率的影响。本观察性研究分析了国家癌症研究所数据库(2002-2017 年)中至少有一例口腔癌住院病例的所有巴西城市。为每个城市收集了以下信息:人口规模、市级人类发展指数(MHDl)、基尼系数、初级保健中的口腔健康覆盖率、牙科专门中心(DSC)数量以及首次治疗后一年的绝对死亡频率。通过 COX 回归确定风险比,通过危害比衡量预测变量对病例发生率的影响。使用泊松回归确定与更高死亡率频率相关的因素。人口超过 50,000 人的城市、MHDl 较高或非常高、更不平等(基尼系数>0.4)、初级保健中的口腔健康覆盖率较低(<50%)且没有 DSC 的城市,其发生 1 例或更多病例的累积风险更高(<0.001)。更高的死亡率频率也与更大的人口规模、更高的 MHDl、更高的基尼系数和更低的初级保健中的口腔健康覆盖率相关(<0.001)。巴西的口腔癌住院和死亡人数受到城市人口规模、人口社会经济地位和公共牙科服务的可用性的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be60/7795570/019539da6079/ijerph-18-00238-g001.jpg

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