保健差异对不同种族和民族背景卵巢癌患者的经历和生存的影响的综述。

IF 1.4 Q4 ONCOLOGY Journal of Cancer Metastasis and Treatment Pub Date : 2019-01-01 Epub Date: 2019-02-27 DOI:10.20517/2394-4722.2018.25
Matthew Kaufman, Ana Cruz, Janese Thompson, Srinivasa Reddy, Nisha Bansal, Joshua G Cohen, Yanyuan Wu, Jay Vadgama, Robin Farias-Eisner
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引用次数: 7

摘要

卵巢癌(OC)是一种严重的疾病,通常出现在晚期,死亡率高,目前的早期筛查模式缺乏敏感性和特异性。卵巢癌通常表现为无症状,这使得早期诊断变得困难。此外,许多患者缺乏明显的危险因素或家族史。由于不同的社会障碍,不同种族、民族和社会群体的OC患者的5年生存率存在差异。这篇综述文章旨在介绍目前关于不同种族、人口统计和社会经济背景的OC患者之间的医疗保健差异的现有数据,以及下一步应该采取什么措施来更好地理解并最终消除这些潜在的破坏性医疗保健差异。越来越多的数据支持这样一种观点,即基因组、社会经济地位、社会因素和文化差异的结合导致了不同的治疗,从而导致了医疗保健的差异。虽然基因组和生物学因素很重要,但语言障碍、地理和旅行障碍、人群之间共病可能性的差异以及不同的治疗方案似乎对不同背景的患者的5年生存率有更大的影响。语言障碍限制了共同决策的护理模式。在资源和设备受限的环境中,交通限制和地理差异可能导致随访有限和护理不足。有这些障碍的患者也往往有更高的合并症发生率,从而提高了OC的死亡率。进一步的研究需要探索有效的解决方案,以弥合医疗保健差距,并了解其发生的原因。
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A review of the effects of healthcare disparities on the experience and survival of ovarian cancer patients of different racial and ethnic backgrounds.

Ovarian cancer (OC) is a serious condition that often presents at advanced stages and has high mortality rates, with the current mode of early-stage screening lacking sensitivity and specificity. OC often presents asymptomatically, which renders early diagnosis difficult. Furthermore, many patients lack significant risk factors or family history of the disease. Five-year survival rates differ between patients with OC among racial, ethnic, and social groups as a result of different social barriers. This review article aims to present the currently existing data regarding health care disparities among OC patients of different ethnic, demographic, and socioeconomic backgrounds, and what next steps should be taken to better understand and eventually eliminate these potentially devastating health care disparities. Increasing data support the notion that a combination of genomic, socioeconomic status, social factors, and cultural differences lead to differential treatments and therefore health care disparities. While genomic and biological factors are important, language barriers, geographic and travel barriers, differences in comorbidity likelihood between populations, and different treatment plans seem to have a greater impact on 5-year survival rates of patients from diverse backgrounds. Language barriers limit a shared-decision model of care. Transportation limitations and geographic differences can lead to limited follow-up and insufficient care in resource and equipment restrictive settings. Patients with these barriers also tend to have a higher incidence of comorbidities that raise the mortality rate of OC. Further research needs to explore effective solutions to bridge health care disparities and understand why they occur.

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来源期刊
CiteScore
3.20
自引率
5.30%
发文量
460
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