Transcript 2006
Combined effect of individual and neighborhood SES in esophageal cancer 2013/7/16 吳晉嘉 • • • • • • Topic Literature Review Coding sheet of literature Introduction Result Limitation • Combined effect of individual and neighborhood SES in esophageal cancer Literature Review • Combined effect of individual and neighborhood SES in gastric cancer patients Literature. • Pubmed: “socioeconomic status” AND “esophageal cancer” Coding Sheet No Journal Year Title Authors Main conclusion 1 NEJM 2003 Esophageal cancer Enzinger Review of esophageal cancer 2 BMC cancer 2012 incidence and survival of esophageal and gastric Coupland cancer incidence and survival.Primary prevention 3 Indian journal of cancer Risk factors and survival analysis of the esophageal Sehgal cancer in the population of Jammu, India snuff, salt tea, smoking and sundried food are the most powerful risk factor of esophageal cancer. improve economic status 4 Asian Pacific journal of 2011 cancer prevention Epidemiologic risk factors fir esiohageal cacer Mao development Rsik factors and EC development Nitrosamine, tabacco abd alcohol, BE and GERDm nutrition, HPV BJC 2006 Role of SES in decision making on dx and tx of esophageal cancer in Netherlands individual SES related to histology . Higher SES related to resection. Lower SES: stent. High SES: more C/T but not significant 2004 Trends and SES inequality Coleman in cancer survival 5 6 BJC 2012 Vliet Deprived patients not benefitial from earlier diagnosis and treatment Ref: Dixon, High SES more resources SES , staging and treat decisions in EC 7 JCGE 8 international journal of 2009 epidemiolog y SES, population based case control study in high risk Islami area,Iran high SES, low risk. 9 Journal of epidemiol 2001 Coomunity health Neighborhood SES and health outcomes Pickett Neighborhood SES rekated to health outcom 10 Cancer epidemiolog 2005 y SES and esophageal adenocarcinoma in Sweden Jansson individual SES related EAC and ESC, high ==> low. Especially without partner. 11 health and quality of life 2009 outcomes Quality of life as prognostic factor in cancer Montazeri survival. Fatigue, physical function PLOS one Sociodemographic and geographical factor in EC and GC mortality in Sweden neighborhood : density high ==> poorer outcome. Single: poorer. High education: better outcome 12 2012 2013 BUS Curative treatment==> similar SES related to tx survival. Neighborhood. High choice.Netherlan. Related to ==> curative resection, or patient and physician?? CCRT ==> better survival Ljung Individual. Multiple SES measures. Occupation, area, education high SES, low risk. Disadvantaged group ==> lower survival but not significant Canada remove SES inequality more than US 13 EJC 2008 Sociol inequality, incidence and survival of EC and GC Baastrup and PC in Denmark 14 JCO 1999 Community income and cancer survival 2006 Impact if SES ib death rate after surgery for UGI Leigh cancer After surgery, social deprivation significant associated mortality Boyd 15 BJC 16 CA: cancer J 2011 clin Global cancer statistics Jemal Statistics 17 international journal of 2007 epidemiolog y SES, risk of GC and EC in European Nagel GC related to SES, others no specific. Ann Surg Oncol. Outcome of Patients with Esophageal Cancer: A Chen Nationwide Analysis. 18 2013 age, sex, and curative treatment were significant predictors of lifetime survival in patients with esophageal cancer. • SES related to esophageal cancer incidence. • In developed country EAC and ESCC related to high SES ( Denmark ) • In developing countries ESCC related to low SES • SES related to treatment choice of esophageal cancer • Surgery improved outcome • Low Neighborhood SES related higher postesophagectomy mortality. • Plos one 2013 : neighborhood and individual SES, but no combination. • Limited literature about combined effect of neighborhood and individual SES Study Design • Taiwan’s NHIRD for the years 2002 to 2006. • 6557 Esophageal cancer patient • Combined Individual SES and neighborhood SES survival • Individual: occupation and insurance income • Neighborhood: average household income 台灣不分性別 每10萬人口標準化發生率 (2000年世界標準人口)，2002-2006年 食道 個案數 平均年齡 年齡中位數 標準化率 癌症百分比 2002 1,310 61 61 5.47 2.08% 2003 1,356 61 61 5.42 2.14% 2004 1,534 60 59 5.99 2.16% 2005 1,527 59 58 5.76 2.13% 2006 1,764 59 57 6.44 2.34% 年度 7,491 國健局網站 癌登系統 <65 years old 食道 年度 個案數 平均年齡 年齡中位數 標準化率 癌症百分比 2002 787 52 52 3.65 2.34% 2003 810 52 52 3.61 2.41% 2004 963 52 52 4.17 2.56% 2005 983 51 51 4.07 2.58% 2006 1,175 52 52 4.74 2.95 >65years old 食道 年度 個案數 平均年齡 年齡中位數 標準化率 癌症百分比 2002 523 74 73 25.78 1.77% 2003 546 74 74 25.69 1.84% 2004 571 74 73 26.4 1.72% 2005 544 74 73 24.61 1.62% 2006 589 75 74 25.47 1.66% Limitation • No staging ( If limited to curative resection, may overcome this bias ) previous review showed that the most important factor is “curative resection” • No histopathological report ( more than 90% in Asian is SCC )