大韩民国跨收入水平的癌症的总生存率差异
Disparities in Overall Survival Rates for Cancers across Income Levels in the Republic of Korea
影响因子:4.40000
分区:医学3区 / 肿瘤学3区
发表日期:2024 Aug 22
作者:
Su-Min Jeong, Kyu-Won Jung, Juwon Park, Hyeon Ji Lee, Dong Wook Shin, Mina Suh
摘要
癌症患者的总体存活率一直在提高。但是，在社会经济地位之间，生存的增加并不统一。因此，我们调查了癌症患者和时间趋势的5年生存率（5YSR）的收入差异。这项研究使用了2002年至2018年的国家癌症队列，该研究是通过将韩国中央癌症注册表和国家健康保险服务（NHIS）索赔数据库联系起来来确定的，以计算韩国共和国共和国的收入水平的癌症存活率。从2002年开始提供生存数据，分析基于精算方法。我们比较了2002 - 2006年最早可用的5年期间的生存以及2014 - 2018年最新可用的5年期，直到2021年12月31日。收入水平分为六类：医疗援助受益人和五个NHIS子类型，根据保险费。不等式的斜率指数（SII）和不等式的相对指数分别通过收入来衡量5YSR的绝对差异和相对差异。所有癌症的2002-2006至2014-2018时期之间的5YSR改善了。在研究期间，在肺，肝脏和胃癌中观察到了5年生存率（5YSR）的显着提高。肺（17.5，95％置信区间（CI）7.0-28.1），肝脏（15.1，95％CI 10.9-19.2），胃（13.9，95％CI 3.2-24.7），结直（11.4，11.4，95％CI 0.9-22.0）和较高的癌症是95％，95％，95％，95％，95％，95％，95％，胃（13.9，95％）（13.9，95％）（13.9，95％CI 3.2-24.7）（13.9，95％CI 3.2-24.7），胃（15.1，95％CI 10.9-19.2）的生存率SII（15.1，95％CI 10.9-19.2），胃（13.9，95％CI 3.2-24.7）。意味着随着收入水平的增加，生存率较高。在研究期间，肺，肝脏和胃癌的SII增加，而甲状腺，乳房，宫颈，前列腺和结直肠癌的SII减少。尽管在2002年至2018年之间观察到了5YSR的大幅改善，但这种增加的癌症类型和收入水平在2002年至2018年之间，这一增加并不均匀地分布在收入水平上。我们的研究表明，癌症患者的生存期，尤其是肺癌和肝癌的持续收入差异。
Abstract
The overall survival rates among cancer patients have been improving. However, the increase in survival is not uniform across socioeconomic status. Thus, we investigated income disparities in the 5-year survival rate (5YSR) in cancer patients and the temporal trends.This study used a national cancer cohort from 2002 to 2018 that was established by linking the Korea Central Cancer Registry and the National Health Insurance Service (NHIS) claim database to calculate the cancer survival rate by income level in the Republic of Korea. Survival data were available from 2002 onward, and the analysis was based on the actuarial method. We compared the survival of the earliest available 5-year period of 2002-2006 and the latest available 5-year period of 2014-2018, observing until 31 December 2021. Income level was classified into six categories: Medical Aid beneficiaries and five NHIS subtypes according to insurance premium. The slope index of inequality (SII) and relative index of inequality were used to measure absolute and relative differences in 5YSR by income, respectively.The 5YSR between the 2002-2006 and 2014-2018 periods for all cancers improved. A significant improvement in 5-year survival rates (5YSR) over the study period was observed in lung, liver, and stomach cancer. The SII of survival rates for lung (17.5, 95% confidence interval (CI) 7.0-28.1), liver (15.1, 95% CI 10.9-19.2), stomach (13.9, 95% CI 3.2-24.7), colorectal (11.4, 95% CI 0.9-22.0), and prostate (10.7, 95% CI 2.5-18.8) cancer was significantly higher, implying higher survival rates as income levels increased. The SII for lung, liver, and stomach cancer increased, while that of thyroid, breast, cervical, prostate, and colorectal cancer decreased over the study period.Although substantial improvement in the 5YSR was observed across cancer types and income levels from 2002 to 2018, this increase was not uniformly distributed across income levels. Our study revealed persistent income disparities in the survival of cancer patients, particularly for lung and liver cancer.