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种族-民族和社会经济差异对子宫内膜癌治疗的影响:指南的遵循情况。

Racial-Ethnic and Socioeconomic Disparities in Guideline-Adherent Treatment for Endometrial Cancer.

机构信息

Department of Health, Society, and Behavior and the Department of Chicano/Latino Studies, University of California, Irvine, and the Department of Medicine, School of Medicine, Irvine, and the Department of Obstetrics & Gynecology, School of Medicine, Orange, California.

出版信息

Obstet Gynecol. 2021 Jul 1;138(1):21-31. doi: 10.1097/AOG.0000000000004424.

Abstract

OBJECTIVE

To evaluate the association of race-ethnicity and neighborhood socioeconomic status with adherence to National Comprehensive Cancer Network guidelines for endometrial carcinoma.

METHODS

Data are from the SEER (Surveillance, Epidemiology, and End Results) cancer registry of women diagnosed with endometrial carcinoma for the years 2006-2015. The sample included 83,883 women after inclusion and exclusion criteria were applied. Descriptive statistics, bivariate analyses, univariate, and multivariate logistic regression models were performed to evaluate the association between race-ethnicity and neighborhood socioeconomic status with adherence to treatment guidelines.

RESULTS

After controlling for demographic and clinical covariates, Black (odds ratio [OR] 0.89, P<.001), Latina (OR .92, P<.001), and American Indian or Alaska Native (OR 0.82, P=.034) women had lower odds of receiving adherent treatment and Asian (OR 1.14, P<.001) and Native Hawaiian or Pacific Islander (OR 1.19 P=.012) women had higher odds of receiving adherent treatment compared with White women. After controlling for covariates, there was a gradient by neighborhood socioeconomic status: women in the high-middle (OR 0.89, P<.001), middle (OR 0.84, P<.001), low-middle (OR 0.80, P<.001), and lowest (OR 0.73, P<.001) neighborhood socioeconomic status categories had lower odds of receiving adherent treatment than the those in the highest neighborhood socioeconomic status group.

CONCLUSIONS

Findings from this study suggest there are racial-ethnic and neighborhood socioeconomic disparities in National Comprehensive Cancer Network treatment adherence for endometrial cancer. Standard treatment therapies should not differ based on sociodemographics. Interventions are needed to ensure that equitable cancer treatment practices are available for all individuals, regardless of racial-ethnic or socioeconomic background.

摘要

目的

评估种族-民族和社区社会经济地位与子宫内膜癌患者遵循国家综合癌症网络指南之间的关联。

方法

数据来自于 2006 年至 2015 年期间被诊断患有子宫内膜癌的妇女的 SEER(监测、流行病学和最终结果)癌症登记处。在应用纳入和排除标准后,样本包括 83883 名女性。采用描述性统计、双变量分析、单变量和多变量逻辑回归模型来评估种族-民族和社区社会经济地位与治疗指南遵循之间的关联。

结果

在控制人口统计学和临床协变量后,黑人(比值比 [OR] 0.89,P<.001)、拉丁裔(OR.92,P<.001)和美洲印第安人或阿拉斯加原住民(OR 0.82,P=.034)女性接受治疗的可能性较低,而亚洲女性(OR 1.14,P<.001)和夏威夷原住民或太平洋岛民(OR 1.19,P=.012)接受治疗的可能性较高,与白人女性相比。在控制了协变量后,社区社会经济地位存在梯度:处于中高(OR 0.89,P<.001)、中(OR 0.84,P<.001)、中低(OR 0.80,P<.001)和最低(OR 0.73,P<.001)社区社会经济地位类别的女性接受治疗的可能性低于最高社区社会经济地位组的女性。

结论

本研究的结果表明,子宫内膜癌患者在国家综合癌症网络治疗依从性方面存在种族-民族和社区社会经济差异。标准治疗方案不应因社会人口统计学因素而有所不同。需要采取干预措施,确保所有个人,无论其种族-民族或社会经济背景如何,都能获得公平的癌症治疗实践。

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