Social Determinants of Health and Oral Cavity Cancer Treatment and Survival: A Competing Risk Analysis
| Autor: | Pratima Agarwal, Eric A. Jones, Anand K. Devaiah, Ravi Agrawal |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Social Determinants of Health Population Health literacy Disease Severity of Illness Index Insurance Coverage 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Epidemiology medicine Humans Social determinants of health Healthcare Disparities 030223 otorhinolaryngology education Disease burden Aged Retrospective Studies education.field_of_study Medicaid business.industry Retrospective cohort study Health Status Disparities Middle Aged Louisiana United States Otorhinolaryngology 030220 oncology & carcinogenesis Female Mouth Neoplasms business SEER Program |
| Zdroj: | The Laryngoscope. 130:2160-2165 |
| ISSN: | 1531-4995 0023-852X |
| Popis: | OBJECTIVE Competing risk analysis is a powerful assessment for cancer risk factors and covariates. This method can better elucidate insurance status and other social determinants of health covariates in oral cavity cancer treatment, survival, and disparities. STUDY DESIGN Retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) database. METHODS Data regarding patient characteristics, clinical stage at diagnosis, treatment, and survival data for 20,271 patients diagnosed with oral cavity cancer was extracted from the SEER 18 Regs Research Data including Hurricane Katrina Impacted Louisiana Cases from 1973 to 2014. All statistical analyses were performed using SAS 9.5 (SAS Institute Inc., Cary, NC). The Fine-Gray method for assessing impact, risk, and covariates was employed. RESULTS Medicaid patients presented with later stage disease, larger tumor size, more distant metastases, and more lymph node involvement at diagnosis compared to insured patients. Medicaid patients were less likely to receive cancer-directed surgery. Medicaid status was also associated with worse cancer-specific survival (subhazard ratios 1.87, 95% confidence interval 1.72-2.04, P |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text