PO.PS01.02 · 人群科学
超过45万名癌症患者婚姻状况、居住地和收入的纵向变化：一项基于SEER的分析
Longitudinal changes in marital status, residence, and income among over 450,000 cancer patients: A SEER-based analysis
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
背景：癌症的影响超出临床结局，常常扰乱人际关系、居住稳定性和财务安全。然而，关于此类变化及相关差异的纵向证据仍然有限。
方法：分析了SEER-17（2000-2021年）中诊断为多原发癌症的457,058名成人，评估了首次和末次记录诊断之间婚姻状况、城市化程度和家庭收入的变化。分析按随访间隔分层（短期：2-5年，长期：>5年）。使用调整了多种人口统计学和临床因素的逻辑回归模型估计这些变化的比值比（OR）和95%置信区间（CI）。
结果：在首次诊断时已婚的患者中（n=255,939），5%变为未婚（离婚/分居/单身），11%丧偶；女性的比例（6%未婚；16%丧偶）高于男性（4%；7%）。非西班牙裔黑人（NHB）女性和西班牙裔女性在短期（8-11%）和长期（11-13%）间隔中变为未婚的比例最高。在从首次到末次诊断保持已婚的患者中（n=214,956），5%改变了城市化程度（1.5%更偏农村；3.4%更偏城市），26%收入发生变化（15%增加；10%减少）。在多变量模型中，与非西班牙裔白人患者相比，NHB患者未婚（未婚或丧偶，短期间隔校正OR=2.47，95% CI 2.24-2.74；长期间隔2.19，2.05-2.34）的几率高出2倍以上，收入减少的几率也更高（短期间隔OR=1.22，1.10-1.36；长期间隔1.44，1.36-1.53）。西班牙裔患者变为未婚的几率也升高（短期间隔OR=1.73，1.56-1.92；长期间隔1.56，1.46-1.67），而非西班牙裔亚裔/太平洋岛民患者收入减少的几率较低（短期间隔OR=0.68，0.59-0.78；长期间隔0.52，0.48-0.57）。
结论：癌症诊断与患者相当程度的社会经济扰动相关，尤其影响女性和弱势种族/族裔人群。这些发现强调了在易受影响的人群中实施以公平为重点的干预措施的重要性，以应对关系紧张、住房稳定性和经济困难。
查看英文原文 English abstract
Background : The impact of cancer extends beyond clinical outcomes, often disrupting interpersonal relationships, residential stability, and financial security. However, longitudinal evidence on such changes and associated disparities remains limited.
Methods : A total of 457,058 adults diagnosed with multiple primary cancers in SEER-17 (2000-2021) were analyzed and changes in marital status, urbanicity, and household income between the first and last recorded diagnoses were assessed. Analyses were stratified by follow-up interval (short: 2-5 and long: >5 years). Logistic regression models adjusted for multiple demographic and clinical factors were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for these changes.
Results : Among patients who were married at first diagnosis (n=255,939), 5% became not married (divorced/separated/single) and 11% were widowed; percentages were higher in women (6% not married; 16% widowed) than men (4%; 7%). Non-Hispanic Black (NHB) women and Hispanic women had the highest proportions becoming not married in both short- (8-11%) and long- (11-13%) intervals. Among patients who remained married from first to last diagnosis (n=214,956), 5% changed urbanicity (1.5% more rural; 3.4% more urban) and 26% changed income (15% increase; 10% decrease). In multivariate models, NHB patients had >2-fold higher odds of being unmarried (not married or widowed, adjusted OR=2.47, 95% CI 2.24-2.74 for short- and 2.19, 2.05-2.34 for long-intervals) and higher odds of income decrease (OR=1.22, 1.10-1.36 for short- and 1.44, 1.36-1.53 for long- interval) compared to non-Hispanic White patients. Hispanic patients also had elevated odds of becoming unmarried (OR=1.73,1.56-1.92 for short- and 1.56, 1.46-1.67 for long- interval), while Non-Hispanic Asian/Pacific Islander patients had lower odds of income decrease (OR=0.68, 0.59-0.78 for short- and 0.52, 0.48-0.57 for long- interval).
Conclusions : Cancer diagnoses are associated with considerable social-economic disturbances for patients, especially impacting women and vulnerable racial/ethnic populations. These findings emphasize the importance of implementing equity-focused interventions in susceptible demographics to address relationship strain, housing stability, and financial hardship.
利益披露 Disclosure
L. M. Zhao, None.