Disparities in the diagnosis and treatment of colorectal cancer among patients with disabilities  

作　　者：Ki Bae Kim Dong Wook Shin Kyoung Eun Yeob So Young Kim Joung-Ho Han Seon Mee Park Jong Heon Park Jong Hyock Park 

机构地区：[1]Department of Internal Medicine,Chungbuk National University Hospital,Chungbuk National University,Cheongju 28644,South Korea [2]Supportive Care Center/Department of Family Medicine,Samsung Medical Center,Sungkyunkwan University School of Medicine,Seoul 06351,South Korea [3]Department of Digital Health,SAIHST,Sungkyunkwan University,Seoul 06355,South Korea [4]Institute of Health&Science Convergence,Chungbuk National University,Cheongju 28644,South Korea [5]Department of Public Health and Preventive Medicine,Chungbuk National University Hospital,Cheongju 28644,South Korea [6]Big Data Steering Department,National Health Insurance Service,Wonju 26464,South Korea [7]College of Medicine/Graduate School of Health Science Business Convergence,Chungbuk National University,Cheongju 28644,South Korea [8]Department of Preventive Medicine,College of Medicine,Chungbuk National University,Cheongju 28644,South Korea

出　　处：《World Journal of Gastrointestinal Oncology》2024年第7期2925-2940,共16页世界胃肠肿瘤学杂志(英文)

基　　金：Supported by the R&D grant from the Korea National Rehabilitation Center Research Institute,Ministry of Health&Welfare,No.2016007;Grants from the National Research Foundation of Korea(NRF)funded by the Ministry of Education,No.2022R1I1A1A01068449 and No.2022R1I1A3070074.

摘　　要：BACKGROUND Little is known about disparities in diagnosis and treatment among colorectal cancer(CRC)patients with and without disabilities.AIM To investigate the patterns of diagnosis,treatment,and survival for people with and without disabilities who had CRC.METHODS We performed a retrospective analysis using the Korean National Health Insurance Service database,disability registration data,and Korean Central Cancer Registry data.The analysis included 21449 patients with disabilities who were diagnosed with CRC and 86492 control patients diagnosed with CRC.RESULTS The overall distribution of CRC stage was not affected by disability status.Subjects with disabilities were less likely than those without disabilities to undergo surgery[adjusted odds ratio(aOR):0.85;95%confidence interval(95%CI):0.82-0.88],chemotherapy(aOR:0.84;95%CI:0.81-0.87),or radiotherapy(aOR:0.90;95%CI:0.84-0.95).The rate of no treatment was higher in patients with disabilities than in those without disabilities(aOR:1.48;95%CI:1.41-1.55).The overall mortality rate was higher in patients with disabilities[adjusted hazard ratio(aHR):1.24;95%CI:1.22-1.28],particularly severe disabilities(aHR:1.57;95%CI:1.51-1.63),than in those without disabilities.CONCLUSION Patients with severe disabilities tended to have a late or unknown diagnosis.Patients with CRC and disabilities had lower rates of treatment with almost all modalities compared with those without disabilities.During the follow-up period,the mortality rate was higher in patients with disabilities than in those without disabilities.The diagnosis and treatment of CRC need improvement in patients with disabilities.

关 键 词：Colorectal cancer DISABILITY STAGE Treatment SURVIVAL 

分 类 号：R73[医药卫生—肿瘤]