Place vs. Pocketbook: Associations of Area-Level and Individual-Level Income on Oral Cavity Cancer Late-Stage Diagnosis

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2025-09-12 DOI:10.1002/cam4.71238

Ethan Tsai, Brighman Walker, Shiao-Chi Wu

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引用次数: 0

Abstract

Background

Late-stage diagnosis of oral cavity cancer (OCC) often results from diagnostic delays due to healthcare access limitations or financial barriers. This study investigates how area-level (“place”) and individual-level (“pocketbook”) income influence the stage at OCC diagnosis.

Methods

This retrospective cohort study analyzed data on patients diagnosed with OCC between 2010 and 2013 sourced from Taiwan's National Cancer Registry and National Health Insurance databases. The primary outcome was late-stage diagnosis, defined as those initially diagnosed at stage III or IV. Multivariable analyses were conducted to estimate the association between area-level, individual-level, and late-stage diagnosis.

Results

This study included 16,652 incident OCC patients, with 6639 (39.9%) diagnosed at a late stage and 10,013 (60.1%) at an early stage. Patients with low individual incomes residing in low-income areas had 1.48 times higher odds (95% CI = 1.09 to 2.00, p = 0.011) of late-stage diagnosis compared to high-income patients in high-income areas. High-income patients; however, in low-income areas had 1.34 times higher odds (95% CI = 1.05 to 1.71, p = 0.02) to be diagnosed at a late stage compared to high-income patients in high-income areas.

Conclusions

While area-level income plays a significant role in late-stage OCC diagnosis, higher individual income does not fully protect against late-stage diagnosis in low-income areas.

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地方与钱包：地区水平和个人水平收入与口腔癌晚期诊断的关系

背景：口腔癌（OCC）的晚期诊断往往是由于医疗准入限制或经济障碍导致的诊断延误。本研究探讨区域水平（“地方”）和个人水平（“钱包”）收入如何影响OCC诊断阶段。主要结局是晚期诊断，定义为最初诊断为III期或IV期的患者。进行多变量分析以估计区域水平、个体水平和晚期诊断之间的关联。结果本研究共纳入16652例OCC患者，其中6639例（39.9%）为晚期诊断，10013例（60.1%）为早期诊断。低收入地区低收入患者的晚期诊断几率是高收入地区高收入患者的1.48倍（95% CI = 1.09 ~ 2.00, p = 0.011）。高收入患者;然而，低收入地区患者晚期诊断的几率是高收入地区患者的1.34倍（95% CI = 1.05 ~ 1.71, p = 0.02）。结论虽然地区收入水平在晚期OCC诊断中起着重要作用，但低收入地区较高的个人收入并不能完全保护晚期OCC的诊断。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.