ABSTRACT

Purpose

A retrospective population-based study to investigate racial and socioeconomic disparities in patients diagnosed with ocular surface squamous neoplasia (OSSN).

Methods

To explore racial disparity, we selected OSSN patients with known age, insurance, gender and zip code-level income and education from the National Cancer Database (NCDB). Comparisons of clinical and socioeconomic variables stratified by race were made with the chi-square or Mann-Whitney tests. Survival outcome was examined a Cox regression model.

Results

Of the 2,402 identified patients from 2004 to 2015, 117 were black. Unadjusted differences were found between groups in regard to age, histology, insurance, income, and education. Black patients in comparison to white patients were younger (mean age: 62 years vs. 70 years; p < .001), represented a higher proportion of Medicaid use (10.3% vs. 3.2%; p < .001) or uninsured (10.3% vs. 2.7%; p < .001), and were more likely to reside in areas of low educational attainment (32.5% vs. 16.1% of whites; p < .001). Multivariate analysis found significantly higher risk of death in patients who were male (HR: 1.66, 95% CI 1.37–2.01) or black (HR: 1.57, 95% CI 1.03–2.38).

Conclusion

Disparities in socioeconomic factors were observed in black patients with OSSN. OSSN occurred earlier in blacks, who were also socioeconomically disadvantaged and faced higher risk of death.

中文翻译：

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眼表鳞状细胞瘤的种族和社会经济差异：国家癌症数据库分析

 抽象的

 目的

一项基于人群的回顾性研究，旨在调查诊断为眼表鳞状细胞瘤 (OSSN) 的患者的种族和社会经济差异。

 方法

为了探讨种族差异，我们从国家癌症数据库 (NCDB) 中选择了年龄、保险、性别和邮政编码级别的收入和教育程度已知的 OSSN 患者。通过卡方检验或曼-惠特尼检验对按种族分层的临床和社会经济变量进行比较。使用 Cox 回归模型检查生存结果。

 结果

2004 年至 2015 年间，共有 2,402 名确诊患者，其中 117 名是黑人。各组之间在年龄、组织学、保险、收入和教育方面发现了未经调整的差异。与白人患者相比，黑人患者更年轻（平均年龄：62 岁 vs. 70 岁； p < .001），使用医疗补助的比例更高（10.3% vs. 3.2%； p < .001）或没有保险（10.3% vs. 2.7%； p < .001），并且更有可能居住在教育程度较低的地区（白人的 32.5% vs. 16.1%； p < .001）。多变量分析发现，男性（HR：1.66，95% CI 1.37-2.01）或黑人（HR：1.57，95% CI 1.03-2.38）患者的死亡风险显着较高。

 结论

在患有 OSSN 的黑人患者中观察到社会经济因素的差异。 OSSN 在黑人中发生得更早，他们在社会经济上也处于不利地位，面临更高的死亡风险。