Fabiola Ramirez, Luis Alvarado, Alok Dwivedi, Jessica Chacon
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引用次数: 0
Abstract
As the deadliest form of skin cancer, advanced-stage melanoma is a devastating disease. Encouragingly, with the introduction of immunotherapy, the overall survival of metastatic melanoma has improved drastically. However, access to novel immunotherapeutic drugs is not universal for all patients. Herein, we examined the association between various sociodemographic factors and the likelihood of using immunotherapy for melanoma treatment. This is a retrospective cohort study using the Texas Cancer Registry data for the years 2011-2018. Multivariable regression analysis was done to evaluate the association between patient characteristics and likelihood of receipt of immunotherapy. The association between sociodemographic factors and likelihood of presentation with metastasis at diagnosis was also examined. Having metastasis at diagnosis was strongly associated with higher odds of receiving immunotherapy (penalized adjusted OR 28.690, 95% CI 23.470-34.350, p < .0001). Compared to having private insurance, patients were less likely to receive immunotherapy if they were uninsured, had Medicare, or had missing/unknown insurance status (penalized adjusted OR's 0.700, 0.790, 0.130, p = .026, 0.027, and p < .0001 respectively). Results from our multivariate model highlighted several factors associated with a higher likelihood of presenting with metastatic disease which included Hispanic ethnicity and black race. Dermatologic disparities affecting the Hispanic population underscore the importance of targeted interventions to overcome community level barriers to melanoma treatment and diagnosis. This study highlights the need to further evaluate different insurance types and their effect on receipt of immunotherapy.
作为最致命的皮肤癌,晚期黑色素瘤是一种毁灭性疾病。令人鼓舞的是,随着免疫疗法的引入,转移性黑色素瘤的总体生存率大幅提高。然而,并非所有患者都能获得新型免疫治疗药物。在此,我们研究了各种社会人口因素与使用免疫疗法治疗黑色素瘤的可能性之间的关联。这是一项回顾性队列研究,使用的是德克萨斯州癌症登记处 2011-2018 年的数据。研究人员通过多变量回归分析评估了患者特征与接受免疫疗法可能性之间的关联。研究还考察了社会人口因素与确诊时出现转移的可能性之间的关联。诊断时出现转移与接受免疫疗法的几率较高密切相关(惩罚性调整 OR 28.690,95% CI 23.470-34.350,p
期刊介绍:
Journal of Immigrant and Minority Health is an international forum for the publication of peer-reviewed original research pertaining to immigrant health from contributors in many diverse fields including public health, epidemiology, medicine and nursing, anthropology, sociology, population research, immigration law, and ethics. The journal also publishes review articles, short communications, letters to the editor, and notes from the field.