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人类发展水平与宫颈癌诊断时的分期相关。

Level of human development is associated with cervical cancer stage at diagnosis.

作者信息

Vale Diama Bhadra, Sauvaget Catherine, Muwonge Richard, Thuler Luiz Claudio Santos, Basu Partha, Zeferino Luiz Carlos, Sankaranarayanan Rengaswamy

机构信息

a Screening Group, International Agency for Research on Cancer (IARC) , Lyon , France.

b Department of Obstetrics and Gynecology , State University of Campinas (Unicamp) , Campinas , Brazil.

出版信息

J Obstet Gynaecol. 2019 Jan;39(1):86-90. doi: 10.1080/01443615.2018.1463976. Epub 2018 Sep 19.

Abstract

The objective was to describe the cervical cancer cases in Brazil by the age-group and stage at diagnosis, and to associate them with the human development index (HDI), where the women live. This was a retrospective study that used data from the Brazilian hospital-based cancer registry from 2005 to 2014. The data were accessed by 5-year age/groups and the federal units. The association between the proportion of cases at Stage I and HDI was estimated in an adjusted linear regression analysis. Among the staged cases, the proportions of cases diagnosed at FIGO Stage I, II, III and IV were 21.2%, 30.7%, 39.9% and 8.2%, respectively. The cases were diagnosed mostly in women aged 45-49 years. There was a significant increase in the proportion of Stage I cases with an increasing HDI (coefficient, 0.46; 95% confidence interval, 0.17-0.76). In conclusion, most of the cases were diagnosed at late stages. The stage at the diagnosis was associated with the human development level. Impact Statement What is already known on this subject? The stage at diagnosis varies according to the level of organisation of the cancer control programme. It is expected that in well-developed programmes there will be a shift to an early stage diagnosis. What the results of this study add? The stage at a diagnosis was associated with the human development level where the women live in Brazil, where most cases were diagnosed at the late stages. What the implications are of these findings for clinical practice and/or further research? This analysis can help with better planning strategies for cancer control. Regional strategies would improve the efficiency of cancer care interventions in countries with large socioeconomic disparities.

摘要

目的是按诊断时的年龄组和分期描述巴西的宫颈癌病例,并将其与女性居住地区的人类发展指数(HDI)相关联。这是一项回顾性研究,使用了2005年至2014年巴西基于医院的癌症登记数据。数据按5岁年龄组和联邦单位获取。在调整线性回归分析中估计了I期病例比例与HDI之间的关联。在分期病例中,国际妇产科联盟(FIGO)I期、II期、III期和IV期诊断病例的比例分别为21.2%、30.7%、39.9%和8.2%。病例大多在45 - 49岁的女性中诊断出来。随着HDI的增加,I期病例的比例显著增加(系数为0.46;95%置信区间为0.17 - 0.76)。总之,大多数病例在晚期诊断出来。诊断时的分期与人类发展水平相关。影响声明关于该主题已知的内容是什么?诊断分期因癌症控制计划的组织水平而异。预计在完善的计划中会转向早期诊断。本研究的结果增加了什么?在巴西,诊断时的分期与女性居住地区的人类发展水平相关,大多数病例在晚期诊断出来。这些发现对临床实践和/或进一步研究有何影响?该分析有助于更好地规划癌症控制策略。区域策略将提高社会经济差距大的国家癌症护理干预措施的效率。

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