사회경제적 상태에 따른 유방암 환자의 생존율 차이
Differences in the Survival Outcomes of Breast Cancer Patients after Mastectomy Based on the Medical Insurance Status
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: In Korea, the national health insurance system covers the entire population. Patients with a lower socioeconomic status are supported by the medical aid system. In this study, we examined the association of the medical insurance status of breast cancer patients with their survival outcomes after mastectomy. Methods: We retrospectively reviewed 117 patients who underwent surgical treatment for breast cancer at the Seoul Medical Center between 1999 and 2012. Patients were stratified into two groups based on their insurance status: the national health insurance registered group (n=85). And the medical aid covered group (n=32). The survival rate was calculated by using the Kaplan-Meier method. Results: The overall 5-year survival rate was 80.0% in the national health insurance group and 73.8% in the medical aid covered group (p=0.039). Multivariate analysis determined that age (p=0.038) and the TNM stage (p=0.035) were independent prognostic factors. The medical insurance status was not a statistically significant prognostic factor for breast cancer patients (p=0.079). Conclusion: The medical insurance status reflects the socioeconomic status of a patient, and thus, it can influence the overall survival of breast cancer patients.
Abstract
Purpose: In Korea, the national health insurance system covers the entire population. Patients with a lower socioeconomic status are supported by the medical aid system. In this study, we examined the association of the medical insurance status of breast cancer patients with their survival outcomes after mastectomy. Methods: We retrospectively reviewed 117 patients who underwent surgical treatment for breast cancer at the Seoul Medical Center between 1999 and 2012. Patients were stratified into two groups based on their insurance status: the national health insurance registered group (n=85). And the medical aid covered group (n=32). The survival rate was calculated by using the Kaplan-Meier method. Results: The overall 5-year survival rate was 80.0% in the national health insurance group and 73.8% in the medical aid covered group (p=0.039). Multivariate analysis determined that age (p=0.038) and the TNM stage (p=0.035) were independent prognostic factors. The medical insurance status was not a statistically significant prognostic factor for breast cancer patients (p=0.079). Conclusion: The medical insurance status reflects the socioeconomic status of a patient, and thus, it can influence the overall survival of breast cancer patients.
참고문헌 (22)
- 정규원, "Survival of Korean Adult Cancer Patients by Stage at Diagnosis, 2006-2010: National Cancer Registry Study", Cancer Research and Treatment, 45(3), pp.162~171 (2013), 대한암학회
- Brewster AM, "Residual risk of breast cancer recurrence 5 years after adjuvant therapy", J Natl Cancer Inst, 100, pp.1179~1183 (2008)
- Liljegren G, "10-Year results after sector resection with or without postoperative radiotherapy for stage I breast cancer : a randomized trial", J Clin Oncol, 17, pp.2326~2333 (1999)
- 김지선, "The Basic Facts of Korean Breast Cancer in 2011: Results of a Nationwide Survey and Breast Cancer Registry Database", Journal of Breast Cancer, 17(2), pp.99~106 (2014), 한국유방암학회
- Høst H, "Age as a prognostic factor in breast cancer", Cancer, 57, pp.2217~2221 (1986)
- Baquet G, "Objectively assessed recess physical activity in girls and boys from high and low socioeconomic backgrounds", BMC Public Health, 14, pp.192~ (2014)
- Vona-Davis L, "The influence of socioeconomic disparities on breast cancer tumor biology and prognosis : a review", J Womens Health(Larchmt), 18, pp.883~893 (2009)
- Dailey AB, "Neighborhood-level socioeconomic predictors of nonadherence to mammography screening guidelines", Cancer Epidemiol Biomarkers Prev, 16, pp.2293~2303 (2007)
- Hahn KM, "Factors associated with advanced disease stage at diagnosis in a population-based study of patients with newly diagnosed breast cancer", Am J Epidemiol, 166, pp.1035~1044 (2007)
- Gorin SS, "Delays in breast cancer diagnosis and treatment by racial", ethnic group, 2006, pp.166, 2244~2252
- Kwon S, "Thirty years of national health insurance in South Korea : lessons for achieving universal health care coverage", Health Policy Plan, 24, pp.63~71 (2009)
- Schrijvers CT, "Deprivation and survival from breast cancer", Br J Cancer, 72, pp.738~743 (1995)
- Carstairs V, "Deprivation indices: their interpretation and use in relation to health", J Epidemiol Community Health, 49(Suppl 2), pp.S3~S8 (1995)
- Pollock AM, "Breast, lung and colorectal cancer incidence and survival in South Thames Region, 1987-1992: the effect of social deprivation", J Public Health Med, 19, pp.288~294 (1997)
- Twelves CJ, "Variation in the survival of women with breast cancer in Scotland. The Scottish Breast Cancer Focus Group and The Scottish Cancer Therapy Network", Br J Cancer, 78, pp.566~571 (1998)
- Kogevinas M, "Socioeconomic differences in cancer survival: a review of the evidence", IARC Sci Publ, (138), pp.177~206 (1997)
- Yim J, "Contribution of income-related inequality and healthcare utilisation to survival in cancers of the lung, liver, stomach and colon", J Epidemiol Community Health, 66, pp.37~40 (2012)
- Azzopardi J, "Surgical treatment for women with breast cancer in relation to socioeconomic and insurance status", Breast J, 20, pp.3~8 (2014)
- Schreiber D, "Racial and socioeconomic disparities in the selection of prostate brachytherapy", J Contemp Brachytherapy, 5, pp.139~143 (2013)
- Nitzkorski JR, "Association of race and socioeconomic status and outcomes of patients with rectal cancer", Ann Surg Oncol, 20, pp.1142~1147 (2013)
- Siemerink EJ, "Disparities in survival of stomach cancer among different socioeconomic groups in North-East Netherlands", Cancer Epidemiol, 35, pp.413~416 (2011)
- Baquet CR, "Socioeconomic factors and breast carcinoma in multicultural women", Cancer, 88(5 Suppl), pp.1256~1264 (2000)