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社会经济地位与癌症的伞式综述

An umbrella review of socioeconomic status and cancer.

机构信息

Department of Biotherapy, West China Hospital and State Key Laboratory of Biotherapy, Sichuan University, Chengdu, China.

Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Nat Commun. 2024 Nov 18;15(1):9993. doi: 10.1038/s41467-024-54444-2.

Abstract

Extensive evidence underscores the pivotal role of socioeconomic status (SES) in shaping cancer-related outcomes. However, synthesizing definitive and actionable insights from the expansive body of literature remains a significant challenge. To elucidate the associations between SES, cancer outcomes, and the overall cancer burden, we conducted a comprehensive burden estimation coupled with an umbrella review of relevant meta-analyses. Our findings reveal that robust or highly suggestive meta-analytic evidence supports only a limited number of these associations. Individuals with lower SES, compared to those with higher SES, are disproportionately disadvantaged by reduced access to immunotherapy, KRAS testing for colorectal cancer, targeted cancer therapies, and precision treatments for melanoma. Additionally, they exhibit lower rates of breast cancer screening and higher incidence rates of lung cancer. Furthermore, countries with a higher Human Development Index demonstrate a substantially greater burden related cancer incidence, with this disparity being more pronounced among men than women.

摘要

大量证据强调了社会经济地位(SES)在塑造癌症相关结局方面的关键作用。然而,从广泛的文献中综合得出明确和可行的见解仍然是一个重大挑战。为了阐明 SES、癌症结局和癌症总体负担之间的关联,我们进行了全面的负担估计,并对相关荟萃分析进行了伞式审查。我们的研究结果表明,只有少数这些关联具有强有力或高度提示性的荟萃分析证据支持。与 SES 较高的人相比,SES 较低的人在获得免疫疗法、结直肠癌的 KRAS 检测、靶向癌症治疗和黑色素瘤的精准治疗方面处于不利地位。此外,他们的乳腺癌筛查率较低,肺癌发病率较高。此外,人类发展指数较高的国家与癌症发病率相关的负担也明显更大,这种差异在男性中比女性中更为明显。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59ea/11574020/b5eb892ff013/41467_2024_54444_Fig1_HTML.jpg

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