Auvinen A, Karjalainen S
National Cancer Institute, Radiation Epidemiology Branch, Bethesda, Maryland 20892, USA.
IARC Sci Publ. 1997(138):377-97.
Social class differences in cancer patient survival have been reported for most cancer types and for a number of countries. The etiology of these differences has been studied less thoroughly and less systematically than social class differences in cancer occurrence. Stage of disease at diagnosis appears to be the most important factor contributing to the social class differences in cancer patient survival. This has been observed most clearly for gastrointestinal and gynaecological cancers. Social class differences in survival are generally wider for patients diagnosed with cancer at local stages than for those diagnosed with cancer at advanced stages. The reasons why cancers are more frequently diagnosed at a local stage in high than in low social classes in not properly understood at the moment. Of other potential contributing factors, the role of treatment and psychosocial factors has scarcely been studied. Biological indicators of tumour aggressiveness have failed to explain the social class differences.
多数癌症类型以及多个国家都报告了癌症患者生存率存在社会阶层差异。相较于癌症发生方面的社会阶层差异，这些差异的病因研究得不够深入，也不够系统。诊断时的疾病阶段似乎是导致癌症患者生存率出现社会阶层差异的最重要因素。这在胃肠道癌和妇科癌症中表现得最为明显。与晚期诊断为癌症的患者相比，局部阶段诊断为癌症的患者生存率的社会阶层差异通常更大。目前尚不清楚为何高社会阶层比低社会阶层的癌症更常被诊断为局部阶段。在其他潜在的影响因素中，治疗和心理社会因素的作用几乎未被研究。肿瘤侵袭性的生物学指标未能解释社会阶层差异。
