A retrospective observational study utilising cancer incidence data from a population-based registry investigated determinants affecting primary liver cancer survival in a southern Italian region with high hepatitis viral infection rates and obesity prevalence. Among 2687 patients diagnosed between 2006 and 2019 (65.3% male), a flexible hazard-based regression model revealed factors influencing 5-year survival rates. High deprivation levels [HR = 1.41 (95%CI = 1.15–1.76);p< 0.001], poor access to care [HR = 1.99 (95%IC = 1.70–2.35);p< 0.0001], age between 65 and 75 [HR = 1.48 (95%IC = 1.09–2.01);p< 0.05] or >75 [HR = 2.21 (95%CI = 1.62–3.01);p< 0.0001] and residing in non-urban areas [HR = 1.35 (95%CI = 1.08–1.69);p< 0.01] were associated with poorer survival estimates. While deprivation appeared to be a risk factor for primary liver cancer patients residing within the urban area, the geographic distance from specialised treatment centres emerged as a potential determinant of lower survival estimates for residents in the non-urban areas. After balancing the groups of easy and poor access to care using a propensity score approach, poor access to care and a lower socioeconomic status resulted in potentially having a negative impact on primary liver cancer survival, particularly among urban residents. We emphasise the need to interoperate cancer registries with other data sources and to deploy innovative digital solutions to improve cancer prevention.
一项基于人群登记数据的回顾性观察研究，调查了意大利南部某地区原发性肝癌患者生存率的影响因素，该地区以高病毒性肝炎感染率和肥胖患病率为特征。研究纳入2006年至2019年间确诊的2687例患者（男性占65.3%），通过灵活风险回归模型分析发现：高度社会经济剥夺[HR = 1.41 (95%CI = 1.15–1.76); p< 0.001]、医疗可及性差[HR = 1.99 (95%CI = 1.70–2.35); p< 0.0001]、年龄65-75岁[HR = 1.48 (95%CI = 1.09–2.01); p< 0.05]或>75岁[HR = 2.21 (95%CI = 1.62–3.01); p< 0.0001]以及居住于非城市地区[HR = 1.35 (95%CI = 1.08–1.69); p< 0.01]均与较差的五年生存率显著相关。研究显示，社会经济剥夺是城市居民原发性肝癌患者的风险因素，而对非城市居民而言，与专科治疗中心的地理距离可能是生存率较低的重要决定因素。通过倾向评分匹配平衡医疗可及性差异后，医疗可及性差与社会经济地位低下对原发性肝癌生存率产生显著负面影响，这一现象在城市居民中尤为突出。我们强调需要加强肿瘤登记系统与其他数据源的互联互通，并部署创新数字解决方案以提升癌症防治水平。
肿瘤(癌症)患者之家