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Abstract：
OBJECTIVE: To explore the relationship between socioeconomic status (SES) and disease mortality in patients with cecal adenocarcinoma in America through the Surveillance, Epidemiology, and End results (SEER) database.
METHODS: The SEER database was queried for patients with cecal adenocarcinoma in America diagnosed from 2011 to 2015. Factor analysis, cluster analysis, and univariate and multivariate Cox proportional hazard models were used for data analysis. Five social security factors were identified: factor 1, economic and educational disadvantage; factor 2, characteristics related to immigration (language isolation and foreign birth); factor 3, high relocation rate in the county; factor 4, high intra-state relocation rate; and factor 5, high domestic relocation rate. Five clusters defined by SES were identified.
RESULTS: The number of all-cause deaths among 17 185 patients was 5948, and the number of survivors was 11, 237. In the multivariate Cox regression analysis, with cluster 1 (low poverty rate and high education level) as the reference, the hazard ratio (HR) of cluster 3 (high intra-county mobility rate) was 1.13 (95% CI: 1.04-1.21, P < 0.05), and the risk was 13% higher than that of cluster 1. The HR of cluster 4 (low language isolation, foreign birth, housing overcrowding, and intra-country mobility rates) was 1.15 (95% CI: 1.07- 1.24, P < 0.001) with a 15% higher risk than cluster 1. The HR of cluster 5 (economic and educational disadvantages, immigration-related characteristics, and low intra-country mobility) was 1.11 (95% CI: 1.03-1.20, P < 0.01) with a 11% higher risk. The factors related to SES indicators were based on the mortality of patients with cecal adenocarcinoma, indicating that low economic and education levels are risk factors for cecal adenocarcinoma.
CONCLUSIONS: Low socioeconomic status is associated with an increased risk of death in patients with cecal adenocarcinoma in the United States and show different distribution patterns based on population. Improving health insurance policies and strengthening psychotherapy can provide guidance for improving prognosis f cecal adenocarcinoma patients.
METHODS: The SEER database was queried for patients with cecal adenocarcinoma in America diagnosed from 2011 to 2015. Factor analysis, cluster analysis, and univariate and multivariate Cox proportional hazard models were used for data analysis. Five social security factors were identified: factor 1, economic and educational disadvantage; factor 2, characteristics related to immigration (language isolation and foreign birth); factor 3, high relocation rate in the county; factor 4, high intra-state relocation rate; and factor 5, high domestic relocation rate. Five clusters defined by SES were identified.
RESULTS: The number of all-cause deaths among 17 185 patients was 5948, and the number of survivors was 11, 237. In the multivariate Cox regression analysis, with cluster 1 (low poverty rate and high education level) as the reference, the hazard ratio (HR) of cluster 3 (high intra-county mobility rate) was 1.13 (95% CI: 1.04-1.21, P < 0.05), and the risk was 13% higher than that of cluster 1. The HR of cluster 4 (low language isolation, foreign birth, housing overcrowding, and intra-country mobility rates) was 1.15 (95% CI: 1.07- 1.24, P < 0.001) with a 15% higher risk than cluster 1. The HR of cluster 5 (economic and educational disadvantages, immigration-related characteristics, and low intra-country mobility) was 1.11 (95% CI: 1.03-1.20, P < 0.01) with a 11% higher risk. The factors related to SES indicators were based on the mortality of patients with cecal adenocarcinoma, indicating that low economic and education levels are risk factors for cecal adenocarcinoma.
CONCLUSIONS: Low socioeconomic status is associated with an increased risk of death in patients with cecal adenocarcinoma in the United States and show different distribution patterns based on population. Improving health insurance policies and strengthening psychotherapy can provide guidance for improving prognosis f cecal adenocarcinoma patients.
摘要：
目的：通过监测探讨美国盲肠腺癌患者的社会经济地位（SES）与疾病死亡率之间的关系，流行病学,和最终结果(SEER)数据库。
方法：在SEER数据库中查询了2011年至2015年在美国确诊的盲肠腺癌患者。因子分析,聚类分析,使用单变量和多变量Cox比例风险模型进行数据分析。确定了五个社会保障因素：因素1，经济和教育劣势；因素2，与移民有关的特征（语言隔离和外国出生）；因素3，该县的高搬迁率；因素4，州内搬迁率高；因素5，国内搬迁率高。确定了SES定义的五个聚类。
结果：17185例患者中的全因死亡人数为5948例，存活人数为11237例。在多元Cox回归分析中，以第1组(低贫困率和高教育水平)为参考，第3组（县内高流动率）的风险比（HR）为1.13（95％CI：1.04-1.21，P<0.05），风险比集群1高13%。第4组的HR(低语言隔离，外国出生，住房过度拥挤，和国内流动率）为1.15（95％CI：1.07-1.24，P<0.001），风险比组1高15％。第5组的人力资源(经济和教育劣势，与移民相关的特征，和低国内流动性）为1.11（95％CI：1.03-1.20，P<0.01），风险更高11％。SES指标的相关因素是基于盲肠腺癌患者的死亡率，表明低经济和教育水平是盲肠腺癌的危险因素。
结论：在美国，低社会经济地位与盲肠腺癌患者的死亡风险增加相关，并根据人群表现出不同的分布模式。改善医疗保险政策和加强心理治疗可以为改善盲肠腺癌患者的预后提供指导。
方法：在SEER数据库中查询了2011年至2015年在美国确诊的盲肠腺癌患者。因子分析,聚类分析,使用单变量和多变量Cox比例风险模型进行数据分析。确定了五个社会保障因素：因素1，经济和教育劣势；因素2，与移民有关的特征（语言隔离和外国出生）；因素3，该县的高搬迁率；因素4，州内搬迁率高；因素5，国内搬迁率高。确定了SES定义的五个聚类。
结果：17185例患者中的全因死亡人数为5948例，存活人数为11237例。在多元Cox回归分析中，以第1组(低贫困率和高教育水平)为参考，第3组（县内高流动率）的风险比（HR）为1.13（95％CI：1.04-1.21，P<0.05），风险比集群1高13%。第4组的HR(低语言隔离，外国出生，住房过度拥挤，和国内流动率）为1.15（95％CI：1.07-1.24，P<0.001），风险比组1高15％。第5组的人力资源(经济和教育劣势，与移民相关的特征，和低国内流动性）为1.11（95％CI：1.03-1.20，P<0.01），风险更高11％。SES指标的相关因素是基于盲肠腺癌患者的死亡率，表明低经济和教育水平是盲肠腺癌的危险因素。
结论：在美国，低社会经济地位与盲肠腺癌患者的死亡风险增加相关，并根据人群表现出不同的分布模式。改善医疗保险政策和加强心理治疗可以为改善盲肠腺癌患者的预后提供指导。
