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Influence of race and sociodemographic factors on declining resection for gastric cancer: A national study.
Schultz, Kurt S; de Geus, Susanna W L; Sachs, Teviah E; Morgan, Ryan B; Ng, Sing Chau; McAneny, David; Tseng, Jennifer F.
Afiliação
  • Schultz KS; Department of Surgery, Boston Medical Center, Boston University, 88 East Newton Street Collamore - C500, Boston, MA, 02118, USA; University of Massachusetts Medical School, 55 North Lake Avenue, Worcester, MA, 01655, USA. Electronic address: kurt.schultz@umassmed.edu.
  • de Geus SWL; Department of Surgery, Boston Medical Center, Boston University, 88 East Newton Street Collamore - C500, Boston, MA, 02118, USA.
  • Sachs TE; Department of Surgery, Boston Medical Center, Boston University, 88 East Newton Street Collamore - C500, Boston, MA, 02118, USA.
  • Morgan RB; Department of Surgery, The University of Chicago, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA.
  • Ng SC; Department of Surgery, Boston Medical Center, Boston University, 88 East Newton Street Collamore - C500, Boston, MA, 02118, USA.
  • McAneny D; Department of Surgery, Boston Medical Center, Boston University, 88 East Newton Street Collamore - C500, Boston, MA, 02118, USA.
  • Tseng JF; Department of Surgery, Boston Medical Center, Boston University, 88 East Newton Street Collamore - C500, Boston, MA, 02118, USA. Electronic address: Jennifer.Tseng@bmc.org.
Am J Surg ; 221(1): 155-161, 2021 01.
Article em En | MEDLINE | ID: mdl-32758359
BACKGROUND: The purpose of this study was to determine whether racial or other demographic characteristics were associated with declining surgery for early stage gastric cancer. METHODS: Patients with clinical stage I-II gastric adenocarcinoma were identified from the NCDB. Multivariable logistic models identified predictors for declining resection. Patients were stratified based on propensity scores, which were modeled on the probability of declining. Overall survival was evaluated using the Kaplan-Meier method. RESULTS: Of 11,326 patients, 3.68% (n = 417) declined resection. Patients were more likely to refuse if they were black (p < 0.001), had Medicaid or no insurance (p < 0.001), had shorter travel distance to the hospital (p < 0.001) or were treated at a non-academic center (p = 0.001). After stratification, patients who declined surgery had worse overall survival (all strata, p < 0.001). CONCLUSIONS: Racial and sociodemographic disparities exist in the treatment of potentially curable gastric cancer, with patients who decline recommended surgery suffering worse overall survival.
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Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 1_ASSA2030 / 2_ODS3 / 6_ODS3_enfermedades_notrasmisibles Base de dados: MEDLINE Assunto principal: Neoplasias Gástricas / Negro ou Afro-Americano / Adenocarcinoma / Asiático / Recusa do Paciente ao Tratamento / População Branca Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Revista: Am J Surg Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 1_ASSA2030 / 2_ODS3 / 6_ODS3_enfermedades_notrasmisibles Base de dados: MEDLINE Assunto principal: Neoplasias Gástricas / Negro ou Afro-Americano / Adenocarcinoma / Asiático / Recusa do Paciente ao Tratamento / População Branca Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Revista: Am J Surg Ano de publicação: 2021 Tipo de documento: Article