塔斯马尼亚的角化细胞癌、地区社会经济地位和地理位置偏远之间的横断面关联和时间趋势。

Keratinocyte carcinomas, area-level socioeconomic status and geographic remoteness in Tasmania: cross-sectional associations and temporal trends.

机构信息

Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.

Cancer Council Queensland, Brisbane, Australia.

出版信息

Aust N Z J Public Health. 2023 Aug;47(4):100067. doi: 10.1016/j.anzjph.2023.100067. Epub 2023 Jun 21.

DOI:10.1016/j.anzjph.2023.100067

PMID:37348166

Abstract

OBJECTIVE

This article aims to examine cross-sectional associations and assess temporal trends in keratinocyte carcinoma (KC) incidence by area-level socioeconomic status (SES) and geographic remoteness in Tasmania, Australia.

METHODS

KCs-basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (SCC)-registered by the Tasmanian Cancer Registry were assigned to area-level SES and remoteness area. Incidence rate ratios (2014-2018) were estimated using Poisson regression. Average annual percentage changes (2001-2018) were estimated using the Joinpoint Regression Program.

RESULTS

BCC incidence increased with increasing area-level advantage (p value for trend <0.001), but no trend was found for SCC. SCC incidence was higher in rural than urban areas (p value <0.001), and BCC incidence was slightly lower in rural than urban areas for males (p value = 0.026), but not for females (p value = 0.381). BCC and SCC incidence increased between 2001 and the mid-2010s, when it peaked across most areas.

CONCLUSIONS

Associations were found between BCC and higher area-level SES, and between SCC and geographic remoteness. The findings suggest differences in sun exposure behaviours, skin cancer awareness and access to services, or ascertainment bias.

IMPLICATIONS FOR PUBLIC HEALTH

Efforts to control and deliver KC services in Tasmania should consider targeting populations with specific area-level characteristics.

摘要

目的

本文旨在探讨澳大利亚塔斯马尼亚地区的社会经济地位（SES）和地理偏远程度与角化细胞癌（KC）发病率之间的横断面关联，并评估其时间趋势。

方法

塔斯马尼亚癌症登记处登记的角化细胞癌（BCC）和皮肤鳞状细胞癌（SCC）被分配到地区社会经济地位和偏远地区。使用泊松回归估计发病率比值（2014-2018 年）。使用 Joinpoint 回归程序估计平均年百分比变化（2001-2018 年）。

结果

BCC 发病率随地区优势的增加而增加（趋势检验 p 值<0.001），但 SCC 无此趋势。与城市地区相比，农村地区 SCC 发病率更高（p 值<0.001），而男性 BCC 发病率在农村地区略低于城市地区（p 值=0.026），但女性则不然（p 值=0.381）。BCC 和 SCC 发病率在 2001 年至 2010 年代中期之间增加，之后在大多数地区达到峰值。