Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark.
Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen; Denmark; National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455 Copenhagen, Denmark.
Gynecol Oncol. 2022 Jan;164(1):98-104. doi: 10.1016/j.ygyno.2021.10.091. Epub 2021 Nov 8.
To examine time trends in ovarian/tubal cancer relative survival, excess mortality, and all-cause mortality for different histological types and levels of socioeconomic position.
Women with ovarian/tubal cancer diagnosed 1996-2017 were identified in the Danish Cancer Registry (n = 11,755). Age-standardized 5-year relative survival over time was estimated by histology, socioeconomic status, and stage. Furthermore, 5-year excess mortality rate ratios (EMRR) according to calendar time for all categories of histology and socioeconomic status were calculated using a Poisson regression model. Finally, all-cause mortality by histology and socioeconomic status was estimated in multivariate Cox proportional hazards regression models.
Statistically significant improvements in 5-year relative survival occurred for all histological types over time except mucinous tumors (5-year EMRR, localized: 0.92 (95% CI: 0.71-1.16); advanced: 0.96 (95% CI: 0.85-1.08). Increase in relative survival over time and corresponding decrease in excess mortality was observed for all categories of socioeconomic status except for women with localized disease in the lowest income group (5-year EMRR = 0.91 (95% CI:0.76-1.10)). The impact of histology and socioeconomic status on all-cause mortality depended on time since diagnosis. Among the socioeconomic factors, especially low educational level and living alone were associated with increased all-cause mortality, particularly in the first year after diagnosis.
Ovarian/tubal cancer survival generally increased over time across histological types and socioeconomic factors. However, the lack of improvement for mucinous tumors needs further research. Additionally, the results for women with low income and education shows that continued focus on social equality in survival is necessary.
研究不同组织学类型和社会经济地位水平的卵巢/输卵管癌相对生存率、超额死亡率和全因死亡率的时间趋势。
在丹麦癌症登记处（n=11755）中确定了 1996-2017 年诊断为卵巢/输卵管癌的女性。通过组织学、社会经济地位和分期来估计随时间推移的年龄标准化 5 年相对生存率。此外，使用泊松回归模型计算了所有组织学类型和社会经济地位的按日历时间分类的 5 年超额死亡率比（EMRR）。最后，使用多变量 Cox 比例风险回归模型估计了按组织学和社会经济地位的全因死亡率。
除黏液性肿瘤外，所有组织学类型的 5 年相对生存率均随时间显著提高（5 年 EMRR，局限性：0.92（95%CI：0.71-1.16）；晚期：0.96（95%CI：0.85-1.08）。所有社会经济地位类别均观察到随时间推移的相对生存率提高和相应的超额死亡率下降，但收入最低组局限性疾病的女性除外（5 年 EMRR=0.91（95%CI：0.76-1.10））。组织学和社会经济地位对全因死亡率的影响取决于诊断后时间。在社会经济因素中，特别是低教育水平和独居与全因死亡率增加有关，尤其是在诊断后的头一年。
卵巢/输卵管癌的生存率总体上随时间在所有组织学类型和社会经济因素中均有所提高。然而，黏液性肿瘤缺乏改善需要进一步研究。此外，低收入和低教育程度女性的结果表明，在生存方面继续关注社会平等是必要的。
