RESUMEN
Background While the incidence and mortality rates of cervical cancer are declining due to improved prevention, screening, and treatment, inequitable access to care may contribute to worse patient outcomes. Therefore, we sought to evaluate sociodemographic disparities in the diagnosis and prognosis of patients with cervical cancer. Methodology The Surveillance, Epidemiology, and End Results (SEER) database was queried for adult women diagnosed with cervical cancer from 2010 to 2015. Sociodemographic groups of interest included patient race/ethnicity (non-Hispanic White/Hispanic White/Black/Other), residential setting (rural/urban), and county median household income (<$45,000/$45,000-59,999/$60,000-74,999/≥$75,000). Outcomes of interest included stage at diagnosis, receipt of hysterectomy, and overall survival (OS). Outcomes were evaluated using Pearson's chi-square test, multivariable logistic regression, and multivariable Cox proportional hazards. Results A total of 5,726 patients were identified with an average age of 50.1 years (SD = 14.6). Significant differences in cancer stage at diagnosis were identified based on race/ethnicity (p < 0.001) and household income (p = 0.012). On adjusted analysis, Black patients were found to be significantly less likely to receive a hysterectomy compared to non-Hispanic White patients (odds ratio (OR) = 0.46; 95% confidence interval (CI) = 0.37-0.56). Lower household income was associated with poorer survival for stage I (<$45,000 vs. >$75,000: hazard ratio (HR) = 1.53; 95% interquartile range (IQR) = 1.00-2.33), II ($45,000-59,999 vs. >$75,000: HR = 1.67; 95% IQR = 1.19-2.35), and IV (<$45,000 vs. >$75,000: HR = 1.64; 95% IQR = 1.22-2.29) disease. Black race was associated with poorer OS for stage IV disease (HR = 1.29; 95% IQR = 1.06-1.56). Conclusions This study highlights significant disparities in disease progression at diagnosis and OS for cervical cancer patients based on race/ethnicity and household income. These findings may assist policymakers in developing strategies for mitigating these disparities.
RESUMEN
Head injury is the leading cause of morbidity, mortality and disability in India. Many such cases present with ENT injuries. ENT manifestations are often associated with varying degree of physical and functional damage. The aim of the study is to determine proportion of ear, nose and throat manifestations in head injury patients and its impact on Quality of Life (QOL). This is an observational prospective study of 98 patients with head injury. Most commonly involved site of injury is nose (38.8%). In ear most commonly affected site is external ear (16.3%). Facial palsy is observed in 5.1% patients. The most common type of injury is abrasion (29.6%). The most commonly fractured facial bone is maxilla (13.3%). At 1 month post injury, 6.5% patients feel their routine activity is limited while 54.4% patients feel depressed. 41.3% patients feel their external appearance has changed and 6.5% patients reported limitations in doing heavy activity. After 3 months limitation in routine activity, feeling of depression and feeling of change in external appearance of face has improved in most patients. Limitation of doing heavy activity has persisted even after 3 months in 6.5% cases. Young male adults are most commonly involved in head injury with nose being the most common site involved and maxilla is the most common bone fractured in ENT manifestations. QOL is affected in almost 50% cases as reported at the end of 1 month which improve in many by 3rd month.