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Stage-specific survival has improved for young breast cancer patients since 2000: but not equally.

自 2000 年以来,年轻乳腺癌患者的分期特异性生存率有所改善: 但并非平等。

  • 影响因子:3.45
  • DOI:10.1007/s10549-020-05698-z
  • 作者列表:"Trewin CB","Johansson ALV","Hjerkind KV","Strand BH","Kiserud CE","Ursin G
  • 发表时间:2020-07-01
Abstract

PURPOSE:The stage-specific survival of young breast cancer patients has improved, likely due to diagnostic and treatment advances. We addressed whether survival improvements have reached all socioeconomic groups in a country with universal health care and national treatment guidelines. METHODS:Using Norwegian registry data, we assessed stage-specific breast cancer survival by education and income level of 7501 patients (2317 localized, 4457 regional, 233 distant and 494 unknown stage) aged 30-48 years at diagnosis during 2000-2015. Using flexible parametric models and national life tables, we compared excess mortality up to 12 years from diagnosis and 5-year relative survival trends, by education and income as measures of socioeconomic status (SES). RESULTS:Throughout 2000-2015, regional and distant stage 5-year relative survival improved steadily for patients with high education and high income (high SES), but not for patients with low education and low income (low SES). Regional stage 5-year relative survival improved from 85 to 94% for high SES patients (9% change; 95% confidence interval: 6, 13%), but remained at 84% for low SES patients (0% change; - 12, 12%). Distant stage 5-year relative survival improved from 22 to 58% for high SES patients (36% change; 24, 49%), but remained at 11% for low SES patients (0% change; - 19, 19%). CONCLUSIONS:Regional and distant stage breast cancer survival has improved markedly for high SES patients, but there has been little survival gain for low SES patients. Socioeconomic status matters for the stage-specific survival of young breast cancer patients, even with universal health care.

摘要

目的: 年轻乳腺癌患者的阶段特异性生存率有所改善,可能是由于诊断和治疗的进步。我们讨论了在一个有全民医疗保健和国民治疗指南的国家,生存改善是否已经达到所有社会经济群体。 方法: 使用挪威注册数据,我们通过教育和收入水平评估了 7501 例患者的分期特异性乳腺癌生存率 (2317 为本地化,4457 为区域性,233 为远距离,494 为未知阶段) 2000-2015 期间诊断时年龄 30-48 岁。使用灵活的参数模型和国民生命表,我们比较了从诊断到 12 年的超额死亡率和 5 年相对生存趋势,按教育和收入作为社会经济地位 (SES) 的衡量标准。 结果: 在整个 2000-2015 期间,高教育和高收入 (高 SES) 患者的区域和远期 5 年相对生存率稳步提高,但不适用于低教育和低收入 (低 SES) 患者。高 SES 患者的区域阶段 5 年相对生存率从 85 提高到 94% (9% 变化; 95% 置信区间: 6,13%),但低 SES 患者仍保持在 84% (0% 变化;-12%)。高 SES 患者的远处阶段 5 年相对生存率从 22 提高到 58% (变化 36%; 24,49%),但低 SES 患者保持在 11% (变化 0%;-19, 19%)。 结论: 高 SES 患者的区域和远期乳腺癌生存率显著提高,但低 SES 患者的生存收益甚微。社会经济地位对年轻乳腺癌患者的阶段特异性生存至关重要,即使有全民医疗保健。

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DOI:10.1042/BSR20192546
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