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首页> 外文期刊>British Journal of Cancer >The role of socio-economic status in the decision making on diagnosis and treatment of oesophageal cancer in The Netherlands
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The role of socio-economic status in the decision making on diagnosis and treatment of oesophageal cancer in The Netherlands

机译：社会经济地位在荷兰食管癌诊治决策中的作用

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In the United States (USA), a correlation has been demonstrated between socio-economic status (SES) of patients on the one hand, and tumour histology, stage of the disease and treatment modality of various cancer types on the other hand. It is unknown whether such correlations are also involved in patients with oesophageal cancer in The Netherlands. Between 1994 and 2003, 888 oesophageal cancer patients were included in a prospective database with findings on the diagnostic work-up and treatment of oesophageal cancer. Socio-economic status of patients was defined as the average net yearly income. Linear-by-linear association testing revealed that oesophageal adenocarcinoma was more frequently observed in patients with higher SES and squamous cell carcinoma in patients with lower SES (P=0.02). Multivariable logistic regression analysis showed no correlation between SES and staging procedures and preoperative TNM stage. The adjusted odds ratio (OR) for stent placement was 0.82 (95% CI 0.71–0.95), indicating that with an increase in SES by 1200?, the likelihood that a stent was placed declined by 18%. Patients with a higher SES more frequently underwent resection or were treated with chemotherapy (OR: 1.15; 95% CI 1.01–1.32 and OR: 1.16; 95% CI 1.02–1.32, respectively). Socio-economic factors are involved in oesophageal cancer in The Netherlands, as patients with a higher SES are more likely to have an adenocarcinoma and patients with a lower SES a squamous cell carcinoma. Moreover, the correlations between SES and different treatment modalities suggest that both patient and doctor determinants contribute to the decision on the most optimal treatment modality in patients with oesophageal cancer.
机译：在美国（美国），一方面已证明患者的社会经济状况（SES）与肿瘤组织学，疾病的阶段以及各种癌症类型的治疗方式之间存在相关性。在荷兰，食管癌患者中是否也涉及这种相关性。在1994年至2003年之间，有888名食道癌患者被纳入前瞻性数据库，其中包括有关食道癌的诊断检查和治疗的发现。患者的社会经济状况定义为平均年净收入。线性逐线性关联测试显示，在SES较高的患者中食管腺癌更为常见，在SES较低的患者中鳞状细胞癌更为常见（P = 0.02）。多变量logistic回归分析显示，SES与分期程序和术前TNM分期之间无相关性。支架放置的调整后优势比（OR）为0.82（95 ％CI 0.71-0.95），表明随着SES增加1200 ?，支架放置的可能性降低了18％。具有较高SES的患者更常接受切除术或接受化疗（分别为OR：1.15; 95％CI 1.01–1.32; OR：1.16; 95％CI 1.02–1.32）。在荷兰，食管癌涉及社会经济因素，因为SES较高的患者更有可能患上腺癌，而SES较低的患者则更容易患鳞状细胞癌。此外，SES与不同治疗方式之间的相关性表明，患者和医生的决定因素都有助于决定食道癌患者的最佳治疗方式。

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