加利福尼亚州 1999-2017 年甲状腺癌的种族/民族差异。
Racial/ethnic disparities in thyroid cancer in California, 1999-2017.
机构信息
UCLA David Geffen School of Medicine, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA.
Department of Biostatistics, UCLA School of Public Health, 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA.
出版信息
Am J Surg. 2023 Feb;225(2):298-303. doi: 10.1016/j.amjsurg.2022.09.041. Epub 2022 Sep 24.
BACKGROUND
Recent studies examining treatment disparities in thyroid cancer care found that appropriate use of surgery and radioactive iodine may be improving over time.
METHODS
California Cancer Registry and California Office of Statewide Health Planning and Development data was evaluated for the effect of race on overall and disease-specific survival for thyroid cancer in California (1999-2017). Reoperation data was also examined. We hypothesized treatment and outcome disparities would persist between Black and white patients.
RESULTS
Black patients with thyroid cancer had worse overall survival than white patients (p < 0.01). No difference was found in disease-specific survival between Black and white patients after adjusting for SES and health insurance status. Black patients underwent reoperation less frequently (1.4%) (HR = 0.70 [CI, 0.50-0.99], p < 0.05) than white patients (2.0%).
CONCLUSIONS
SES and insurance type are drivers of disparities in thyroid cancer survival in Black patients. Addressing social determinants of health or healthcare access are paramount to addressing disparities in thyroid cancer between Black and white patients.
背景
最近研究发现，甲状腺癌治疗中的差异正在逐渐缩小，手术和放射性碘治疗的应用正在变得更加合理。
方法
我们分析了加利福尼亚癌症登记处和加利福尼亚州全州卫生规划与发展办公室的数据，以评估种族对加利福尼亚州甲状腺癌的总体生存率和疾病特异性生存率的影响（1999-2017 年）。我们还研究了再次手术的数据。我们假设黑人患者和白人患者之间的治疗和预后差异会持续存在。
结果
患有甲状腺癌的黑人患者的总体生存率比白人患者差（p<0.01）。调整社会经济地位和医疗保险状况后，黑人患者和白人患者的疾病特异性生存率无差异。黑人患者再次手术的频率较低（1.4%）（HR=0.70 [CI，0.50-0.99]，p<0.05）。
结论
社会经济地位和保险类型是导致黑人甲状腺癌患者生存差异的驱动因素。解决健康或医疗保健获取的社会决定因素对于解决黑人和白人患者之间甲状腺癌的差异至关重要。
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