患者社会经济地位如何影响乳腺癌手术治疗及死亡率？一项快速综述

How Does Patient Socioeconomic Position Affect Breast Cancer Surgical Treatment and Mortality?: A Rapid Review.

作者信息

Schubbe Danielle, Yen Renata W, Durand Marie-Anne

机构信息

The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH, USA.

UMR 1295, CERPOP, Université de Toulouse, INSERM, Université Toulouse II Paul Sabatier, Toulouse, France.

出版信息

Breast Cancer (Dove Med Press). 2021 Oct 27;13:595-601. doi: 10.2147/BCTT.S293635. eCollection 2021.

DOI:10.2147/BCTT.S293635

PMID:34737634

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8558100/

Abstract

BACKGROUND

Breast cancer is the second leading cause of death in women across the world. Despite significant improvements in overall breast cancer survival, disparities still exist. Research shows that socioeconomic position (SEP) plays a strong role in disparities in breast cancer care. Lower SEP can be a predictor of poorer breast cancer health outcomes and treatment received. No recent review has focused on SEP and breast cancer surgery outcomes. We conducted a rapid review assessing how patient SEP affects breast cancer surgical outcomes.

METHODS

We developed and ran the search strategy in Ovid MEDLINE in January 2021. We assessed study eligibility using an adapted version of PICOS criteria. We included observational studies that assessed the relationship between SEP and breast cancer surgery treatment, including outcomes like surgery choice, survival, and wait time to surgery. We independently reviewed each article and independently extracted data using a pre-designed form. One reviewer narratively synthesized the data extracted from the included articles.

RESULTS

We found twelve articles that met inclusion criteria. Eight out of 12 articles showed a difference in breast cancer surgery outcomes based on at least one measure of SEP. Six out of eight articles that collected surgery choice data found that women with lower SEP had lower rates of breast conserving surgery. One out of three articles that collected survival data found that higher SEP had a positive effect on survival. Additionally, one article that collected wait time to surgery data found a significant correlation between lower SEP and longer delays to surgical treatment.

CONCLUSION

In conclusion, our rapid review of SEP and breast cancer surgery outcomes found that there is a relationship between SEP and breast cancer surgery choice. This rapid review did not find enough evidence to see a relationship with overall survival and wait time to surgery.

摘要

背景

乳腺癌是全球女性第二大死因。尽管乳腺癌总体生存率有显著提高，但差异仍然存在。研究表明，社会经济地位（SEP）在乳腺癌护理差异中起着重要作用。较低的SEP可能预示着乳腺癌健康结局较差以及接受的治疗较差。最近没有综述聚焦于SEP与乳腺癌手术结局。我们进行了一项快速综述，评估患者SEP如何影响乳腺癌手术结局。

方法

我们于2021年1月在Ovid MEDLINE中制定并运行了检索策略。我们使用PICOS标准的改编版本评估研究的纳入资格。我们纳入了评估SEP与乳腺癌手术治疗之间关系的观察性研究，包括手术选择、生存率和手术等待时间等结局。我们独立审阅每篇文章，并使用预先设计的表格独立提取数据。一位审阅者对从纳入文章中提取的数据进行了叙述性综合分析。

结果

我们发现12篇文章符合纳入标准。12篇文章中有8篇显示，基于至少一项SEP指标，乳腺癌手术结局存在差异。在收集手术选择数据的8篇文章中，有6篇发现SEP较低的女性保乳手术率较低。在收集生存率数据的3篇文章中，有1篇发现较高的SEP对生存率有积极影响。此外，1篇收集手术等待时间数据的文章发现，SEP较低与手术治疗延迟较长之间存在显著相关性。