Junior Medical Officer, Nepean Hospital, Sydney, New South Wales, Australia.
Senior Subspecialty Trainee, Gynaecological Oncology, Royal Hospital for Women, Sydney, New South Wales, Australia.
Aust N Z J Obstet Gynaecol. 2022 Oct;62(5):714-719. doi: 10.1111/ajo.13553. Epub 2022 Jun 16.
Socio-economic (SE) status is closely linked to health status and the mechanisms of this association are complex. One important adverse effect of SE disadvantage is vulnerability to cancer and cancer is a major cause of morbidity and mortality in Australia.
We aimed to estimate the effect of SE status on mortality rates from ovarian, cervical, and endometrial cancer.
National mortality data were obtained from the Australian Bureau of Statistics (ABS) for the calendar years from 2001 to 2018, inclusive. Individual deaths were grouped by the ABS Index of Relative Socio-economic Advantage and Disadvantage. Population data were obtained to provided denominators allowing calculation of mortality rates (deaths per 100 000 women aged 30-79 years). Statistical analyses performed included tabulating point-estimates of mortality rates and their changes over time and modelling the trends of rates using maximum likelihood method.
Age-standardised mortality rates for ovarian and cervical cancer fell over the study period but increased for endometrial cancer. There was clear evidence of a SE gradient in the mortality rate for all three cancers. This SE gradient increased over the study period for ovarian and cervical cancer but remained unchanged for endometrial cancer.
Women at greater SE disadvantage have higher rates of death from the commonest gynaecological cancers and this gradient has not reduced over the last two decades. After the COVID-19 pandemic efforts must be redoubled to ensure that Australians already at risk of ill health do not face even greater risks because of their circumstances.
社会经济（SE）地位与健康状况密切相关，其关联机制复杂。SE 劣势的一个重要不利影响是易患癌症，而癌症是澳大利亚发病率和死亡率的主要原因。
我们旨在估计 SE 地位对卵巢癌、宫颈癌和子宫内膜癌死亡率的影响。
从澳大利亚统计局（ABS）获得了 2001 年至 2018 年日历年度的全国死亡率数据。ABS 相对社会经济优势和劣势指数将个体死亡进行分组。获得人口数据作为分母，以计算死亡率（每 100000 名 30-79 岁女性的死亡人数）。进行的统计分析包括列出死亡率的点估计值及其随时间的变化，并使用最大似然法对率的趋势进行建模。
研究期间，卵巢癌和宫颈癌的年龄标准化死亡率下降，但子宫内膜癌的死亡率上升。所有三种癌症的死亡率都存在明显的 SE 梯度。卵巢癌和宫颈癌的这种 SE 梯度在研究期间增加，但子宫内膜癌保持不变。
处于更大 SE 劣势的女性死于最常见妇科癌症的死亡率更高，在过去二十年中，这种梯度并未降低。在 COVID-19 大流行之后，必须加倍努力，确保已经面临健康风险的澳大利亚人不会因为自己的情况而面临更大的风险。
