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Socioeconomic and insurance-related disparities in disease-specific survival among patients with metastatic bone disease.
Jawad, Muhammad Umar; Pollock, Brad H; Wise, Barton L; Zeitlinger, Lauren N; O' Donnell, Edmond F; Carr-Ascher, Janai R; Cizik, Amy; Ferrell, Betty; Thorpe, Steven W; Randall, R Lor.
Afiliação
  • Jawad MU; Department of Orthopedic Surgery, Samaritan Health System, Corvallis, Oregon, USA.
  • Pollock BH; Department of Public Health Sciences, UC Davis School of Medicine, Sacramento, California, USA.
  • Wise BL; Department of Internal Medicine, UC Davis School of Medicine, Sacramento, California, USA.
  • Zeitlinger LN; Department of Orthopaedic Surgery, UC Davis School of Medicine, Sacramento, California, USA.
  • O' Donnell EF; Department of Orthopaedic Surgery, UC Davis School of Medicine, Sacramento, California, USA.
  • Carr-Ascher JR; Department of Orthopaedic Surgery, UC Davis School of Medicine, Sacramento, California, USA.
  • Cizik A; Department of Internal Medicine, UC Davis School of Medicine, Sacramento, California, USA.
  • Ferrell B; Department of Orthopaedic Surgery, UC Davis School of Medicine, Sacramento, California, USA.
  • Thorpe SW; Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah, USA.
  • Randall RL; Department of Nursing and Palliative Care, City of Hope, Duarte, California, USA.
J Surg Oncol ; 127(1): 159-173, 2023 Jan.
Article em En | MEDLINE | ID: mdl-36121418
BACKGROUND: Approximately 5% of cancer patients in the United States presented with metastatic bone disease (MBD) at diagnosis. Current study explores the disparities in survival for patients with MBD. METHODS: Patients with the diagnosis of MBD at presentation for the five most common primary anatomical sites were extracted from Surveillance, Epidemiology, and End Results Census tract-level dataset (2010-2016). Kaplan-Meier and Cox Proportional Hazard models were used to evaluate survival, and prognostic factors for each cohort. Prognostic significance of socioeconomic status (SES) and insurance status were ascertained. RESULTS: The five most common anatomical-sites with MBD at presentation included "lung" (n = 59 739), "prostate" (n = 19 732), "breast" (n = 16 244), "renal and urothelium" (n = 7718) and "colon" (n= 3068). Lower SES was an independent risk factor for worse disease-specific survival (DSS) for patients with MBD originating from lung, prostate, breast and colon. Lack of insurance was an independent risk factor for worse DSS for MBD patients with primary tumors in lung and breast. CONCLUSIONS: MBD patients from the five most common primary sites demonstrated SES and insurance-related disparities in disease-specific survival. This is the first and largest study to explore SES and insurance-related disparities among patients specifically afflicted with MBD. Our findings highlight vulnerability of patients with MBD across multiple primary sites to financial toxicity.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Ósseas / Neoplasias Limite: Humans País/Região como assunto: America do norte Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Ósseas / Neoplasias Limite: Humans País/Região como assunto: America do norte Idioma: En Ano de publicação: 2023 Tipo de documento: Article