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加拿大肾癌和肾盂癌死亡率的社会经济不平等:三十年趋势

Socioeconomic inequalities in kidney and renal pelvis cancer mortality in Canada: Trends over three decades.

作者信息

Hajizadeh Mohammad, Nasiri Nazanin, Johnston Grace

机构信息

School of Health Administration, Faculty of Health, Dalhousie University, Canada.

School of Health and Human Performance, Dalhousie University, Halifax, Canada.

出版信息

J Cancer Policy. 2025 Mar;43:100524. doi: 10.1016/j.jcpo.2024.100524. Epub 2024 Dec 3.

Abstract

BACKGROUND

Kidney and renal pelvis cancer (KCa) presents significant health challenges that require investigation. This study measured and examined trends in socioeconomic inequalities in the mortality of KCa in Canada over the period 1990-2019.

METHODS

We constructed a census division level dataset pooled from the Canadian Vital Death Statistics Database (CVSD), the Canadian Census of the Population (CCP), and the National Household Survey (NHS) to measure income and education inequalities in the mortality rate of KCa in Canada over the study period. The age-standardized Concentration index (C), which measures inequality across all socioeconomic groups, was used to quantify income and education inequalities in the mortality of KCa in Canada. Trend analyses evaluated changes in these inequalities over time.

RESULTS

The average crude KCa mortality rates were found to be 5.97 and 3.40 per 100,000 for the male and female populations, respectively. The crude KCa mortality consistently increased over time in eastern but not western Canada. Statistically negative values of the age-standardized C index showed higher KCa mortality in the lower-income and less-educated population, particularly among females, with no changes observed over the 30-year study period.

CONCLUSION

The higher KCa mortality in socioeconomically disadvantaged groups in Canada indicates the continuing need for primary prevention through lowering smoking rates, reducing obesity, and controlling hypertension. Additionally, promoting greater use of abdominal imaging for the incidental early KCa detection can enable more effective treatment and improved survival rates, especially for females of lower socioeconomic status.

摘要

背景

肾癌和肾盂癌(KCa)带来了重大的健康挑战,需要进行调查研究。本研究测量并考察了1990 - 2019年期间加拿大KCa死亡率的社会经济不平等趋势。

方法

我们构建了一个普查区层面的数据集,该数据集汇集了加拿大人口死亡统计数据库(CVSD)、加拿大人口普查(CCP)和全国家庭调查(NHS),以衡量研究期间加拿大KCa死亡率的收入和教育不平等情况。年龄标准化集中指数(C)用于衡量所有社会经济群体之间的不平等,以此量化加拿大KCa死亡率的收入和教育不平等情况。趋势分析评估了这些不平等随时间的变化。

结果

发现男性和女性人群的KCa平均粗死亡率分别为每10万人5.97和3.40。在加拿大东部,KCa粗死亡率随时间持续上升,而西部则不然。年龄标准化C指数的统计负值表明,低收入和受教育程度较低人群的KCa死亡率较高,尤其是女性,在30年的研究期内未观察到变化。

结论

加拿大社会经济弱势群体中较高的KCa死亡率表明,持续需要通过降低吸烟率、减少肥胖和控制高血压来进行一级预防。此外,促进更多地使用腹部成像技术以偶然发现早期KCa,能够实现更有效的治疗并提高生存率,特别是对于社会经济地位较低的女性。

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