{"title":"收入差距对甲状腺癌复发和存活率有重大影响","authors":"","doi":"10.1016/j.jcpo.2024.100511","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>Income inequality profoundly impacts cancer outcomes, yet its specific effects on thyroid cancer remain unclear. Elucidating the influence of socioeconomic disparities is imperative to advance health equity and optimize patient care. This study evaluates associations between median household income and thyroid cancer recurrence and survival using national cancer registry data.</div></div><div><h3>Methods</h3><div>139,302 thyroid cancer patients undergoing surgery from 2000 to 2019 were analyzed from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were categorized by median annual household income at the county level (> or <$75,000). Multivariable regression determined the impact of income on recurrence and overall mortality.</div></div><div><h3>Results</h3><div>Higher-income patients had 26 % lower recurrence odds (OR 0.74, 95 %CI 0.55–0.99, <em>p</em>=0.042) and longer median survival (18.1 vs 17.7 years, <em>p</em><0.001) compared to lower-income patients. On multivariate analysis, high income remained an independent predictor of reduced mortality after adjusting for demographics, tumor factors, and treatment (adjusted HR=0.84, 95 %CI=0.81–0.87, <em>p</em><0.001). Cancer-directed surgery (HR=0.28, 95 %CI=0.26–0.30, <em>p</em><0.001) and radioactive iodine (HR=0.69, 95 %CI=0.66–0.71, <em>p</em><0.001) were associated with lower mortality risk.</div></div><div><h3>Conclusions</h3><div>Income disparities have a significant influence on thyroid cancer outcomes, including lower recurrence and reduced mortality. Targeting socioeconomic inequity could substantially reduce recurrence, improve survival, and promote health equity for all patients.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Income disparities have a significant impact on thyroid cancer recurrence and survival\",\"authors\":\"\",\"doi\":\"10.1016/j.jcpo.2024.100511\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>Income inequality profoundly impacts cancer outcomes, yet its specific effects on thyroid cancer remain unclear. Elucidating the influence of socioeconomic disparities is imperative to advance health equity and optimize patient care. This study evaluates associations between median household income and thyroid cancer recurrence and survival using national cancer registry data.</div></div><div><h3>Methods</h3><div>139,302 thyroid cancer patients undergoing surgery from 2000 to 2019 were analyzed from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were categorized by median annual household income at the county level (> or <$75,000). Multivariable regression determined the impact of income on recurrence and overall mortality.</div></div><div><h3>Results</h3><div>Higher-income patients had 26 % lower recurrence odds (OR 0.74, 95 %CI 0.55–0.99, <em>p</em>=0.042) and longer median survival (18.1 vs 17.7 years, <em>p</em><0.001) compared to lower-income patients. On multivariate analysis, high income remained an independent predictor of reduced mortality after adjusting for demographics, tumor factors, and treatment (adjusted HR=0.84, 95 %CI=0.81–0.87, <em>p</em><0.001). Cancer-directed surgery (HR=0.28, 95 %CI=0.26–0.30, <em>p</em><0.001) and radioactive iodine (HR=0.69, 95 %CI=0.66–0.71, <em>p</em><0.001) were associated with lower mortality risk.</div></div><div><h3>Conclusions</h3><div>Income disparities have a significant influence on thyroid cancer outcomes, including lower recurrence and reduced mortality. Targeting socioeconomic inequity could substantially reduce recurrence, improve survival, and promote health equity for all patients.</div></div>\",\"PeriodicalId\":38212,\"journal\":{\"name\":\"Journal of Cancer Policy\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-10-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Cancer Policy\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2213538324000456\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH POLICY & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cancer Policy","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2213538324000456","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}
引用次数: 0
摘要
目的:收入不平等会对癌症的治疗结果产生深远影响,但其对甲状腺癌的具体影响仍不清楚。阐明社会经济差异的影响对于促进健康公平和优化患者护理至关重要。本研究利用全国癌症登记数据评估了家庭收入中位数与甲状腺癌复发和生存率之间的关系。方法:研究人员从监测、流行病学和最终结果(SEER)数据库中分析了2000-2019年间接受手术的139302名甲状腺癌患者。根据县级家庭年收入中位数对患者进行分类(> 或 结果:高收入患者的复发几率低26%(OR 0.74,95%CI 0.55-0.99,p=0.042),中位生存期长(18.1年 vs 17.7年,p结论:收入差距对甲状腺癌的治疗效果有重大影响,包括降低复发率和死亡率。针对社会经济方面的不平等可大大降低复发率,提高生存率,促进所有患者的健康公平。
Income disparities have a significant impact on thyroid cancer recurrence and survival
Purpose
Income inequality profoundly impacts cancer outcomes, yet its specific effects on thyroid cancer remain unclear. Elucidating the influence of socioeconomic disparities is imperative to advance health equity and optimize patient care. This study evaluates associations between median household income and thyroid cancer recurrence and survival using national cancer registry data.
Methods
139,302 thyroid cancer patients undergoing surgery from 2000 to 2019 were analyzed from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were categorized by median annual household income at the county level (> or <$75,000). Multivariable regression determined the impact of income on recurrence and overall mortality.
Results
Higher-income patients had 26 % lower recurrence odds (OR 0.74, 95 %CI 0.55–0.99, p=0.042) and longer median survival (18.1 vs 17.7 years, p<0.001) compared to lower-income patients. On multivariate analysis, high income remained an independent predictor of reduced mortality after adjusting for demographics, tumor factors, and treatment (adjusted HR=0.84, 95 %CI=0.81–0.87, p<0.001). Cancer-directed surgery (HR=0.28, 95 %CI=0.26–0.30, p<0.001) and radioactive iodine (HR=0.69, 95 %CI=0.66–0.71, p<0.001) were associated with lower mortality risk.
Conclusions
Income disparities have a significant influence on thyroid cancer outcomes, including lower recurrence and reduced mortality. Targeting socioeconomic inequity could substantially reduce recurrence, improve survival, and promote health equity for all patients.