Despite advances in cancer screening, late-stage cancer diagnosis is still a major cause of morbidity and mortality in the United States. In this study, we aim to understand demographic and geographic factors associated with receiving a late-stage diagnosis (LSD) of lung, colorectal, breast, or cervical cancer. (1) Methods: We analyzed data of patients with a cancer diagnosis between 2016 and 2020 from the Florida Cancer Data System (FCDS), a statewide population-based registry. To investigate correlates of LSD, we estimated multi-variable logistic regression models for each cancer while controlling for age, sex, race, insurance, and census tract rurality and poverty. (2) Results: Patients from high-poverty rural areas had higher odds for LSD of lung (OR = 1.23, 95% CI (1.10, 1.37)) and breast cancer (OR = 1.31, 95% CI (1.17,1.47)) than patients from low-poverty urban areas. Patients in high-poverty urban areas saw higher odds of LSD for lung (OR = 1.05 95% CI (1.00, 1.09)), breast (OR = 1.10, 95% CI (1.06, 1.14)), and cervical cancer (OR = 1.19, 95% CI (1.03, 1.37)). (3) Conclusions: Financial barriers contributing to decreased access to care likely drive LSD for cancer in rural and urban communities of Florida.
尽管癌症筛查技术不断进步，晚期癌症诊断在美国仍是导致发病和死亡的主要原因。本研究旨在探讨与肺癌、结直肠癌、乳腺癌及宫颈癌晚期诊断相关的人口统计学和地理学因素。(1)方法：我们分析了佛罗里达州癌症数据系统（全州人口登记数据库）中2016至2020年间确诊癌症患者的资料。通过构建多变量逻辑回归模型，在控制年龄、性别、种族、保险状况、人口普查区 rurality（城乡属性）及贫困程度等变量后，分别评估各类癌症晚期诊断的相关因素。(2)结果：与低贫困度城市地区患者相比，高贫困度农村地区患者的肺癌（OR=1.23，95%CI[1.10，1.37]）和乳腺癌（OR=1.31，95%CI[1.17，1.47]）晚期诊断风险显著升高。高贫困度城市地区患者的肺癌（OR=1.05，95%CI[1.00，1.09]）、乳腺癌（OR=1.10，95%CI[1.06，1.14]）及宫颈癌（OR=1.19，95%CI[1.03，1.37]）晚期诊断风险亦显著增加。(3)结论：经济障碍导致的医疗可及性下降，可能是佛罗里达州城乡社区癌症晚期诊断的重要驱动因素。
肿瘤(癌症)患者之家