量化社区社会经济脆弱性的影响，因为它与子宫癌治疗和生存方面的种族差异有关。这项回顾性队列研究纳入了 2004 年至 2017 年在纽约州接受子宫切除术的诊断为子宫癌的患者。计算了通过区域剥夺指数量化的社区社会经济脆弱性。主要结局是遵循指南治疗；次要结果是 5 年总生存率。最终队列中共有 34,356 名患者。居住在弱势社区与接受适当辅助化疗（59.7% vs. 75.7%，aRR = 0.81；95% CI，0.77-0.86）和及时手术（63.7% vs. 74.5%，aRR = 0.85；95% CI，0.77-0.86）和及时手术的可能性相关。 95% CI，0.82-0.87）。与富裕社区相比，居住在弱势社区的人的全因死亡率高 24%（aHR = 1.24；95% CI，1.16-1.32）。黑人/白人 5 年总生存率的最大种族差异出现在最富裕的社区，为 18.6%，其中白人患者的生存率为 79.8%，黑人患者的生存率为 61.2%（aHR 1.31；95% CI 1.14-1.51）。对于晚期疾病患者来说，这种差异是由于白人患者的生存率随着社区富裕程度的增加而提高，但黑人患者的生存率没有变化。在控制年龄、合并症、保险、肿瘤组织学、分期和等级的调整分析中，纽约市最富裕社区的差距仍然最大（aHR = 1.59；95%CI 1.26-1.2.01）。社区社会经济脆弱性与此相关子宫癌患者的预后较差。最大的黑人/白人生存差距出现在最富裕的社区。社区富裕程度可能不会影响晚期子宫内膜癌黑人患者的生存。版权所有 © 2024 Elsevier Inc. 保留所有权利。

To quantify the effect of neighborhood socioeconomic vulnerability as it relates to racial disparity in uterine cancer treatment and survival.Patients with a diagnosis of uterine cancer who underwent hysterectomy in New York State from 2004 to 2017 were included in this retrospective cohort study. Neighborhood socioeconomic vulnerability as quantified by the Area Deprivation Index was calculated. Primary outcome was guideline adherent treatment; secondary outcome was 5 year overall survival.A total of 34,356 patients were included in the final cohort. Residence within a vulnerable neighborhood was associated with a lower likelihood of receiving appropriate adjuvant chemotherapy (59.7% vs 75.7% with aRR = 0.81; 95% CI, 0.77-0.86) and timely surgery (63.7% vs. 74.5% with aRR = 0.85; 95% CI, 0.82-0.87). All-cause mortality was 24% higher for those who resided in vulnerable neighborhoods compared to affluent neighborhoods (aHR = 1.24; 95% CI, 1.16-1.32). The greatest Black/White racial disparity in 5 year overall survival was seen in the most affluent neighborhoods at 18.6%, with survival being 79.8% for White patients and 61.2% for Black patients (aHR 1.31; 95% CI 1.14-1.51). For patients with advanced stage disease, this disparity was driven by improved survival for White patients with increasing neighborhood affluence but no change in survival for Black patients. On adjusted analysis controlling for age, comorbidities, insurance, tumor histology, stage, and grade, the disparity remained widest in the most affluent neighborhoods in NYC (aHR = 1.59; 95%CI 1.26-1.2.01).Neighborhood socioeconomic vulnerability is associated with poor outcomes for patients with uterine cancer. The greatest Black/White survival disparities are in the wealthiest neighborhoods. Neighborhood affluence may not affect survival of Black patients with advanced stage endometrial cancer.Copyright © 2024 Elsevier Inc. All rights reserved.