PDF(Pubmed)
Abstract：
Introduction: Long-standing disparities in colorectal cancer (CRC) outcomes and survival between Whites and Blacks have been observed. A person-centered approach using latent class analysis (LCA) is a novel methodology to assess and address CRC health disparities. LCA can overcome statistical challenges from subgroup analyses that would normally impede variable-centered analyses like regression. Aim was to identify risk profiles and differences in malignant CRC survivorship outcomes. Methods: We conducted an LCA on the Surveillance, Epidemiology, and End Results data from 1975 to 2016 for adults ≥18 (N = 525,245). Sociodemographics used were age, sex/gender, marital status, race, and ethnicity (Hispanic/Latinos) and stage at diagnosis. To select the best fitting model, we employed a comparative approach comparing sample-size adjusted BIC and entropy; which indicates a good separation of classes. Results: A four-class solution with an entropy of 0.72 was identified as: lowest survivorship, medium-low, medium-high, and highest survivorship. The lowest survivorship class (26% of sample) with a mean survival rate of 53 months had the highest conditional probabilities of being 76-85 years-old at diagnosis, female, widowed, and non-Hispanic White, with a high likelihood with localized staging. The highest survivorship class (53% of sample) with a mean survival rate of 92 months had the highest likelihood of being married, male with localized staging, and a high likelihood of being non-Hispanic White. Conclusion: The use of a person-centered measure with population-based cancer registries data can help better detect cancer risk subgroups that may otherwise be overlooked.
摘要：
简介：已经观察到白人和黑人在结直肠癌（CRC）结局和生存率方面的长期差异。使用潜在类别分析（LCA）的以人为中心的方法是一种评估和解决CRC健康差异的新颖方法。LCA可以克服来自亚组分析的统计挑战，这些挑战通常会阻碍回归等以变量为中心的分析。目的是确定恶性CRC生存结局的风险概况和差异。方法：我们对监测进行了LCA，流行病学,和1975年至2016年≥18岁成年人的最终结果数据(N=525,245)。使用的社会人口统计学是年龄，性别/性别,婚姻状况,种族,和种族（西班牙裔/拉丁裔）和诊断阶段。要选择最佳拟合模型，我们采用了一种比较方法，比较了样本量调整后的BIC和熵；这表明类别的分离很好。结果：熵为0.72的四类解决方案被确定为：最低存活率，中低,中高,和最高的存活率。平均存活率为53个月的最低生存率（占样本的26％）在诊断时具有最高的条件概率为76-85岁，女性,寡妇,和非西班牙裔白人,局部分期的可能性很高。平均生存率为92个月的最高生存率（占样本的53％）结婚的可能性最高，男性局部分期，而且很有可能成为非西班牙裔白人.结论：使用以人群为基础的癌症登记数据以人为中心的措施可以帮助更好地检测可能被忽视的癌症风险亚组。
