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Disparities in the Diagnosis and Treatment of Gastric Cancer in Relation to Disabilities

We investigated potential disparities in the diagnosis, treatment, and survival of gastric cancer (GC) patients with and without disabilities. METHODS: We linked Korean National Disability Registry data with the Korean National Health Insurance database and Korean Central Cancer Registry data. This...

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Autores principales: Kim, Hyoung Woo, Shin, Dong Wook, Yeob, Kyoung Eun, Cho, In Young, Kim, So Young, Park, Seon Mee, Park, Jong Heon, Park, Jong Hyock, Kawachi, Ichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7544185/
https://www.ncbi.nlm.nih.gov/pubmed/33108122
http://dx.doi.org/10.14309/ctg.0000000000000242
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author Kim, Hyoung Woo
Shin, Dong Wook
Yeob, Kyoung Eun
Cho, In Young
Kim, So Young
Park, Seon Mee
Park, Jong Heon
Park, Jong Hyock
Kawachi, Ichiro
author_facet Kim, Hyoung Woo
Shin, Dong Wook
Yeob, Kyoung Eun
Cho, In Young
Kim, So Young
Park, Seon Mee
Park, Jong Heon
Park, Jong Hyock
Kawachi, Ichiro
author_sort Kim, Hyoung Woo
collection PubMed
description We investigated potential disparities in the diagnosis, treatment, and survival of gastric cancer (GC) patients with and without disabilities. METHODS: We linked Korean National Disability Registry data with the Korean National Health Insurance database and Korean Central Cancer Registry data. This study included a total of 16,849 people with disabilities and 58,872 age- and sex-matched control subjects in whom GC had been diagnosed. RESULTS: When compared to GC patients without disabilities, patients with disabilities tended to be diagnosed at a later stage (localized stage 53.7% vs 59.0% or stage unknown 10.7% vs 6.9%), especially those with severe disabilities (P < 0.001). This was more evident in patients with mental impairment (localized stage 41.7% and stage unknown 15.2%). In addition, not receiving treatment was more common in patients with disabilities than those without disabilities (29.3% vs 27.2%, P < 0.001), and this disparity was more evident in those with severe disabilities (35.4%) and in those with communication (36.9%) and mental (32.3%) impairment. Patients with disabilities were at slightly higher risk of overall mortality as well as GC-specific mortality compared to people without disabilities (adjusted hazard ratio [aHR] = 1.18, 95% confidence interval: 1.14–1.21 and aHR = 1.12, 95% confidence interval: 1.09–1.16, respectively), and these disparities were more pronounced in those with severe disabilities (aHR = 1.62 and 1.51, respectively). DISCUSSION: Patients with disabilities, especially severe disabilities, were diagnosed with GC at a later stage, received less staging evaluation and treatment, and their overall survival rate was slightly worse compared to those without disabilities.
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spelling pubmed-75441852020-10-30 Disparities in the Diagnosis and Treatment of Gastric Cancer in Relation to Disabilities Kim, Hyoung Woo Shin, Dong Wook Yeob, Kyoung Eun Cho, In Young Kim, So Young Park, Seon Mee Park, Jong Heon Park, Jong Hyock Kawachi, Ichiro Clin Transl Gastroenterol Article We investigated potential disparities in the diagnosis, treatment, and survival of gastric cancer (GC) patients with and without disabilities. METHODS: We linked Korean National Disability Registry data with the Korean National Health Insurance database and Korean Central Cancer Registry data. This study included a total of 16,849 people with disabilities and 58,872 age- and sex-matched control subjects in whom GC had been diagnosed. RESULTS: When compared to GC patients without disabilities, patients with disabilities tended to be diagnosed at a later stage (localized stage 53.7% vs 59.0% or stage unknown 10.7% vs 6.9%), especially those with severe disabilities (P < 0.001). This was more evident in patients with mental impairment (localized stage 41.7% and stage unknown 15.2%). In addition, not receiving treatment was more common in patients with disabilities than those without disabilities (29.3% vs 27.2%, P < 0.001), and this disparity was more evident in those with severe disabilities (35.4%) and in those with communication (36.9%) and mental (32.3%) impairment. Patients with disabilities were at slightly higher risk of overall mortality as well as GC-specific mortality compared to people without disabilities (adjusted hazard ratio [aHR] = 1.18, 95% confidence interval: 1.14–1.21 and aHR = 1.12, 95% confidence interval: 1.09–1.16, respectively), and these disparities were more pronounced in those with severe disabilities (aHR = 1.62 and 1.51, respectively). DISCUSSION: Patients with disabilities, especially severe disabilities, were diagnosed with GC at a later stage, received less staging evaluation and treatment, and their overall survival rate was slightly worse compared to those without disabilities. Wolters Kluwer 2020-10-08 /pmc/articles/PMC7544185/ /pubmed/33108122 http://dx.doi.org/10.14309/ctg.0000000000000242 Text en © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Article
Kim, Hyoung Woo
Shin, Dong Wook
Yeob, Kyoung Eun
Cho, In Young
Kim, So Young
Park, Seon Mee
Park, Jong Heon
Park, Jong Hyock
Kawachi, Ichiro
Disparities in the Diagnosis and Treatment of Gastric Cancer in Relation to Disabilities
title Disparities in the Diagnosis and Treatment of Gastric Cancer in Relation to Disabilities
title_full Disparities in the Diagnosis and Treatment of Gastric Cancer in Relation to Disabilities
title_fullStr Disparities in the Diagnosis and Treatment of Gastric Cancer in Relation to Disabilities
title_full_unstemmed Disparities in the Diagnosis and Treatment of Gastric Cancer in Relation to Disabilities
title_short Disparities in the Diagnosis and Treatment of Gastric Cancer in Relation to Disabilities
title_sort disparities in the diagnosis and treatment of gastric cancer in relation to disabilities
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7544185/
https://www.ncbi.nlm.nih.gov/pubmed/33108122
http://dx.doi.org/10.14309/ctg.0000000000000242
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