头颈部癌症的生存不平等：基于医院的队列研究。

Survival inequalities in head and neck cancers: A hospital-based cohort study.

机构信息

Department of Health Education, Federal University of Sergipe, Lagarto, Brazil.

Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.

出版信息

Head Neck. 2023 Sep;45(9):2377-2393. doi: 10.1002/hed.27433. Epub 2023 Jul 4.

DOI:10.1002/hed.27433

PMID:37401537

Abstract

BACKGROUND

We investigated whether the socioeconomic status (SES) influenced survival rates in oropharynx cancers (OPC), oral cavity cancers (OCC), and larynx cancers (LC) in Brazilian patients.

METHODS

This hospital-based cohort study assessed the age-standardized 5-year relative survival (RS) using the Pohar Perme estimator.

RESULTS

Overall, we identified 37 191 cases, and 5-year RS were 24.4%, 34.1%, and 44.9% in OPC, OCC, and LC, respectively. In multiple Cox regression, the highest risk of death occurred in the most vulnerable social strata for all subsites-that is, illiterates or patients relying on publicly funded healthcare services. Disparities increased over time by 34.9% in OPC due to the rising of survival rates in the highest SES, whereas they reduced by 10.2% and 29.6% in OCC and LC.

CONCLUSIONS

The potential inequities were more significant for OPC than for OCC and LC. It is urgent to tackle social disparities to improve prognoses in highly unequal countries.

摘要

背景

我们研究了社会经济地位（SES）是否会影响巴西患者口咽癌（OPC）、口腔癌（OCC）和喉癌（LC）的生存率。

方法

这项基于医院的队列研究使用 Pohar Perme 估计器评估了年龄标准化的 5 年相对生存率（RS）。

结果

总体而言，我们共确定了 37191 例病例，OPC、OCC 和 LC 的 5 年 RS 分别为 24.4%、34.1%和 44.9%。在多变量 Cox 回归分析中，所有亚部位中最脆弱的社会阶层的死亡风险最高，即文盲或依赖公共资助医疗服务的患者。由于 SES 最高组的生存率上升，OPC 的差异在过去 34.9%的时间里一直在增加，而 OCC 和 LC 的差异则分别减少了 10.2%和 29.6%。