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首页> 外文期刊>Cancer causes and control: CCC >Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: National Longitudinal Mortality Study.
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Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: National Longitudinal Mortality Study.

机译：社会经济状况对癌症发病率和诊断阶段的影响：从监测，流行病学和最终结果中选择的发现：国家纵向死亡率研究。

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BACKGROUND: Population-based cancer registry data from the Surveillance, Epidemiology, and End Results (SEER) Program at the National Cancer Institute (NCI) are mainly based on medical records and administrative information. Individual-level socioeconomic data are not routinely reported by cancer registries in the United States because they are not available in patient hospital records. The U.S. representative National Longitudinal Mortality Study (NLMS) data provide self-reported, detailed demographic and socioeconomic data from the Social and Economic Supplement to the Census Bureau's Current Population Survey (CPS). In 1999, the NCI initiated the SEER-NLMS study, linking the population-based SEER cancer registry data to NLMS data. The SEER-NLMS data provide a new unique research resource that is valuable for health disparity research on cancer burden. We describe the design, methods, and limitations of this data set. We also present findings on cancer-related health disparities according to individual-level socioeconomic status (SES) and demographic characteristics for all cancers combined and for cancers of the lung, breast, prostate, cervix, and melanoma. METHODS: Records of cancer patients diagnosed in 1973-2001 when residing 1 of 11 SEER registries were linked with 26 NLMS cohorts. The total number of SEER matched cancer patients that were also members of an NLMS cohort was 26,844. Of these 26,844 matched patients, 11,464 were included in the incidence analyses and 15,357 in the late-stage diagnosis analyses. Matched patients (used in the incidence analyses) and unmatched patients were compared by age group, sex, race, ethnicity, residence area, year of diagnosis, and cancer anatomic site. Cohort-based age-adjusted cancer incidence rates were computed. The impact of socioeconomic status on cancer incidence and stage of diagnosis was evaluated. RESULTS: Men and women with less than a high school education had elevated lung cancer rate ratios of 3.01 and 2.02, respectively, relative to their college educated counterparts. Those with family annual incomes less than Dollars 12,500 had incidence rates that were more than 1.7 times the lung cancer incidence rate of those with incomes Dollars 50,000 or higher. Lower income was also associated with a statistically significantly increased risk of distant-stage breast cancer among women and distant-stage prostate cancer among men. CONCLUSIONS: Socioeconomic patterns in incidence varied for specific cancers, while such patterns for stage were generally consistent across cancers, with late-stage diagnoses being associated with lower SES. These findings illustrate the potential for analyzing disparities in cancer outcomes according to a variety of individual-level socioeconomic, demographic, and health care characteristics, as well as by area measures available in the linked database.
机译：背景：来自国家癌症研究所（NCI）的监测，流行病学和最终结果（SEER）计划的基于人群的癌症登记数据主要基于医疗记录和行政信息。在美国，癌症登记处并未常规报告个人级别的社会经济数据，因为患者医院的记录中没有这些数据。美国代表性的国家纵向死亡率研究（NLMS）数据提供了从社会和经济补编到人口普查局当前人口调查（CPS）的自我报告的详细人口和社会经济数据。 NCI在1999年启动了SEER-NLMS研究，将基于人群的SEER癌症登记数据与NLMS数据联系起来。 SEER-NLMS数据提供了一种新的独特研究资源，对于癌症负担方面的健康差异研究非常有价值。我们描述了该数据集的设计，方法和局限性。我们还根据个人水平的社会经济状况（SES）和所有合并的癌症以及肺癌，乳腺癌，前列腺癌，子宫颈癌和黑色素瘤的人口统计学特征，介绍了与癌症相关的健康差异。方法：居住在11个SEER注册中心中的1个中，1973-2001年诊断出的癌症患者的记录与26个NLMS队列相关。也是NLMS队列成员的SEER匹配癌症患者总数为26,844。在这26844名匹配的患者中，有11464名被纳入了发病率分析，而15357名被纳入了后期诊断分析。对匹配的患者（用于发生率分析）和不匹配的患者按年龄组，性别，种族，种族，居住地区，诊断年份和癌症解剖部位进行比较。计算了基于队列的年龄调整后的癌症发生率。评估了社会经济状况对癌症发病率和诊断阶段的影响。结果：初中以下文化程度的男性和女性相对于大学学历的女性，肺癌发生率分别升高3.01和2.02。家庭年收入低于12,500美元的人群，其发病率是收入高于50,000美元或更高的人群的1.7倍以上。较低的收入还与女性中远期乳腺癌和男性中远期前列腺癌的风险统计学上显着增加有关。结论：特定癌症的发病率的社会经济模式各不相同，而癌症的分期模式通常是一致的，晚期诊断与较低的SES有关。这些发现说明了根据各种个体水平的社会经济，人口统计学和医疗保健特征以及链接数据库中可用的面积测量方法分析癌症结果差异的潜力。

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