دورية أكاديمية
Socioeconomic inequality in prostate cancer diagnostics, primary treatment, rehabilitation, and mortality in Sweden.
العنوان: | Socioeconomic inequality in prostate cancer diagnostics, primary treatment, rehabilitation, and mortality in Sweden. |
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المؤلفون: | Strömberg U; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.; Department of Research and Development, Region Kronoberg, Växjö, Sweden., Berglund A; EpiStat AB, Uppsala, Sweden., Carlsson S; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.; Department of Urology, Karolinska University Hospital Solna, Stockholm, Sweden., Thellenberg Karlsson C; Department of Diagnostics and Intervention, Oncology, Umeå University, Umeå, Sweden., Lambe M; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden., Lissbrant IF; Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden., Stattin P; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden., Bratt O; Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.; Department of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden. |
المصدر: | International journal of cancer [Int J Cancer] 2024 Aug 15; Vol. 155 (4), pp. 637-645. Date of Electronic Publication: 2024 Mar 25. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Wiley-Liss Country of Publication: United States NLM ID: 0042124 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-0215 (Electronic) Linking ISSN: 00207136 NLM ISO Abbreviation: Int J Cancer Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 1995- : New York, NY : Wiley-Liss Original Publication: 1966-1984 : Genève : International Union Against Cancer |
مواضيع طبية MeSH: | Prostatic Neoplasms*/mortality , Prostatic Neoplasms*/pathology , Prostatic Neoplasms*/diagnosis , Prostatic Neoplasms*/rehabilitation , Socioeconomic Factors* , Magnetic Resonance Imaging*/methods, Humans ; Male ; Sweden/epidemiology ; Aged ; Middle Aged ; Healthcare Disparities/statistics & numerical data ; Registries ; Aged, 80 and over |
مستخلص: | We designed a nationwide study to investigate the association between socioeconomic factors (household income and education) and different aspects of prostate cancer care, considering both individual- and neighbourhood-level variables. Data were obtained from Prostate Cancer data Base Sweden (PCBaSe), a research database with data from several national health care registers including clinical characteristics and treatments for nearly all men diagnosed with prostate cancer in Sweden. Four outcomes were analysed: use of pre-biopsy magnetic resonance imaging (MRI) in 2018-2020 (n = 11,843), primary treatment of high-risk non-metastatic disease in 2016-2020 (n = 6633), rehabilitation (≥2 dispensed prescriptions for erectile dysfunction within 1 year from surgery in 2016-2020, n = 6505), and prostate cancer death in 7770 men with high-risk non-metastatic disease diagnosed in 2010-2016. Unadjusted and adjusted odds and hazard ratios (OR/HRs) with 95% confidence intervals (CIs) were calculated. Adjusted odds ratio (ORs) comparing low versus high individual education were 0.74 (95% CI 0.66-0.83) for pre-biopsy MRI, 0.66 (0.54-0.81) for primary treatment, and 0.82 (0.69-0.97) for rehabilitation. HR gradients for prostate cancer death were significant on unadjusted analysis only (low vs. high individual education HR 1.41, 95% CI 1.17-1.70); co-variate adjustments markedly attenuated the gradients (low vs. high individual education HR 1.10, 95% CI 0.90-1.35). Generally, neighbourhood-level analyses showed weaker gradients over the socioeconomic strata, except for pre-biopsy MRI. Socioeconomic factors influenced how men were diagnosed with prostate cancer in Sweden but had less influence on subsequent specialist care. Neighbourhood-level socioeconomic data are more useful for evaluating inequality in diagnostics than in later specialist care. (© 2024 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.) |
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معلومات مُعتمدة: | 200719 Cancerfonden; REG-969400 Västra Götalandsregionen |
فهرسة مساهمة: | Keywords: diagnosis; mortality; prostate cancer; socioeconomic factors; treatment |
تواريخ الأحداث: | Date Created: 20240325 Date Completed: 20240619 Latest Revision: 20240619 |
رمز التحديث: | 20240619 |
DOI: | 10.1002/ijc.34932 |
PMID: | 38526118 |
قاعدة البيانات: | MEDLINE |
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