综合医疗服务系统中卵巢癌患者手术时间的种族和民族差异。

IF 14.8 2区 医学 Q1 ONCOLOGY
Amrita Mukherjee, Devansu Tewari, Rombod Rahimian, Qiaoling Chen, Michael Batech, Patricia Wride, Sandra Sappington, Chun R Chao
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引用次数: 0

摘要

背景:非裔美国妇女卵巢癌存活率的差异是多因素造成的。我们评估了综合医疗系统成员中卵巢癌手术时间的种族和民族差异:在这项回顾性队列研究中,我们确定了 2008 年 1 月 1 日至 2014 年 12 月 31 日期间在美国一家综合医疗保健系统中确诊为浸润性上皮型卵巢癌的女性。我们从医疗保健系统的癌症登记和电子健康记录中提取了癌症相关变量和社会人口变量的数据。我们纳入了接受卵巢癌手术但未接受新辅助化疗的患者。我们将手术时间定义为从诊断成像检查到手术之间的天数。我们使用 Cox 比例危险度回归来评估种族和族裔与手术时间的粗略关联和调整关联:在纳入的872名患者中,55.1%为非西班牙裔白人(以下简称白人),24.9%为西班牙裔,14.6%为亚洲/太平洋岛民(PI)/美国本地人,5.5%为非裔美国人。确诊时的中位年龄为 59.0 岁。与其他种族和族裔群体相比,非裔美国人患者的确诊年龄更大,更有可能来自贫困社区。与白人、西班牙裔和亚裔/PI/美国本土患者相比,非裔美国人患者的中位手术时间更长(中位天数分别为 27.5 天 vs 21.0 天、24.5 天和 26.0 天;PConclusions:我们的研究结果表明,与白人患者相比,少数种族和族裔的卵巢癌患者在诊断成像后的任何给定时间内接受手术的可能性都较低,这表明在获得医疗服务机会相对平等的患者中,卵巢癌手术时间存在种族和族裔差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Racial and Ethnic Disparities in the Time to Ovarian Cancer Surgery in Patients at an Integrated Health Care Delivery System.

Background: Disparities in ovarian cancer survival for African American women are multifactorial. We evaluated racial and ethnic differences in time to ovarian cancer surgery in members of an integrated health care system.

Patients and methods: In this retrospective cohort study, we identified women diagnosed with invasive epithelial-type ovarian cancer between January 1, 2008, through December 31, 2014, at an integrated health care system in the United States. We extracted data on cancer-related variables and sociodemographic variables from the health care system's cancer registry and electronic health records. We included patients who received ovarian cancer surgery without neoadjuvant chemotherapy. We defined time to surgery as the number of days between diagnostic imaging study and surgery. We used Cox proportional hazards regression to evaluate crude and adjusted association of race and ethnicity with time to surgery.

Results: Of 872 patients included, 55.1% were non-Hispanic White (hereafter, White), 24.9% were Hispanic, 14.6% were Asian/Pacific Islander (PI)/Native American, and 5.5% were African American. Median age at diagnosis was 59.0 years. African American patients were diagnosed at an older age and were more likely to come from deprived neighborhoods than other racial and ethnic groups. Median time to surgery was longer for African American patients compared with White, Hispanic, and Asian/PI/Native American patients (median days: 27.5 vs 21.0, 24.5, and 26.0, respectively; P<.0001). In adjusted models, the likelihood of having received surgery at any given time post diagnostic imaging was 31% lower for African American patients compared with White patients (HR, 0.69; 95% CI, 0.51-0.93). This likelihood was also lower for Hispanic and Asian/PI/Native American patients, but not statistically significant.

Conclusions: Our findings showed that patients with ovarian cancer from racial and ethnic minorities had a lower likelihood of having received surgery at any given time post diagnostic imaging compared with White patients, demonstrating that racial and ethnic differences exist in time to ovarian cancer surgery in patients with relatively equal access to care.

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来源期刊
CiteScore
20.20
自引率
0.00%
发文量
388
审稿时长
4-8 weeks
期刊介绍: JNCCN—Journal of the National Comprehensive Cancer Network is a peer-reviewed medical journal read by over 25,000 oncologists and cancer care professionals nationwide. This indexed publication delivers the latest insights into best clinical practices, oncology health services research, and translational medicine. Notably, JNCCN provides updates on the NCCN Clinical Practice Guidelines in Oncology® (NCCN Guidelines®), review articles elaborating on guideline recommendations, health services research, and case reports that spotlight molecular insights in patient care. Guided by its vision, JNCCN seeks to advance the mission of NCCN by serving as the primary resource for information on NCCN Guidelines®, innovation in translational medicine, and scientific studies related to oncology health services research. This encompasses quality care and value, bioethics, comparative and cost effectiveness, public policy, and interventional research on supportive care and survivorship. JNCCN boasts indexing by prominent databases such as MEDLINE/PubMed, Chemical Abstracts, Embase, EmCare, and Scopus, reinforcing its standing as a reputable source for comprehensive information in the field of oncology.
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