The population of cancer survivors is increasing rapidly in the UK. Little is known about the variation in comorbidity and mortality by ethnicity and socio-economic condition in this population. This study explores these variations using primary care data from the Clinical Practice Research Datalink (CPRD) and linked secondary care data. The prevalence of multimorbidity and risk of mortality were calculated for Asian, Black, and Other ethnic and socio-economic groups in England, consisting of 333,226 cancer survivors across 28 cancer types. Odds ratios and hazard ratios were calculated using the White and most affluent groups as references and adjusted for age, sex, BMI, and smoking status. Stratified mortality analysis was conducted for survivors of the six common cancers in the UK: breast, prostate, colorectal, bladder, cervical, and lung. Compared to White cancer survivors, survivors of all other ethnic groups had a statistically significant higher prevalence of type 2 diabetes (Asian adjusted odds ratio (OR) 4.61 (4.02–5.28), Black OR 1.87 (1.52–2.30), and Other OR 2.06 (1.64–2.59)). However, they had lower prevalences of depression and anxiety. Asian survivors exhibited the highest overall prevalence of comorbidity. Black survivors had the worst survival (adjusted hazard ratio (HR) 1.48 (1.38–1.59)) for all cancers combined, as well as for breast, prostate, colorectal, and cervical cancers. Black breast cancer survivors face a particularly high mortality risk (HR 1.78 (1.52–2.10)) compared to Whites. Asian survivors had higher mortality for all cancers combined (HR 1.31 (1.23–1.39)) and specifically for lung cancer (HR 1.81 (1.44–2.28)). The Other ethnic group had a significantly increased risk of mortality in cervical cancer (HR 1.90 (1.19–3.03)). The risk of mortality increased with worse socio-economic conditions, regardless of ethnic group. Cancer survivors of non-White ethnicity and poorer socio-economic background in the UK have worse outcomes in terms of increased prevalence of multimorbidity and mortality compared to White survivors. These findings indicate the need to comprehend the underlying reasons for these disparities and to assess the implications for cancer services, patient experience, and overall outcomes.
英国癌症幸存者数量正快速增长。目前对该群体中不同族裔和社会经济状况人群的共病及死亡率差异了解甚少。本研究利用英国临床实践研究数据链（CPRD）的初级诊疗数据及关联的二级诊疗数据，对英格兰地区亚裔、黑人及其他族裔与社会经济群体中的333,226名涵盖28种癌症类型的幸存者进行了分析，计算了多重共病患病率及死亡风险。研究以白人族群和最富裕群体为参照，通过比值比和风险比（经年龄、性别、体重指数及吸烟状况校正）进行量化，并针对英国六种常见癌症（乳腺癌、前列腺癌、结直肠癌、膀胱癌、宫颈癌和肺癌）幸存者进行了分层死亡率分析。 结果显示：与白人癌症幸存者相比，所有其他族裔群体的2型糖尿病患病率均显著更高（亚裔校正比值比4.61（4.02–5.28）、黑人1.87（1.52–2.30）、其他族裔2.06（1.64–2.59）），但抑郁和焦虑患病率较低。亚裔幸存者的总体共病患病率最高。黑人幸存者在所有癌症合并分析中死亡率最高（校正风险比1.48（1.38–1.59）），在乳腺癌、前列腺癌、结直肠癌和宫颈癌中亦如此，其中黑人乳腺癌幸存者死亡风险尤为突出（风险比1.78（1.52–2.10））。亚裔幸存者在所有癌症合并分析中死亡率较高（风险比1.31（1.23–1.39）），尤其在肺癌中更为显著（风险比1.81（1.44–2.28））。其他族裔群体在宫颈癌中的死亡风险显著增加（风险比1.90（1.19–3.03））。无论族裔为何，社会经济状况越差，死亡风险越高。 研究表明，与美国白人幸存者相比，非白人及社会经济地位较低的癌症幸存者在多重共病患病率和死亡率方面结局更差。这些发现提示需要深入理解导致这些差异的根本原因，并评估其对癌症医疗服务、患者体验及整体预后的影响。
肿瘤(癌症)患者之家