台灣低收入戶與非低收入戶10年癌症盛行率差異及相關分析

Analysis of difference on cancer prevalence between low income households and non-low income households and their association with cancer in ten years in Taiwan

莊薰仰(Shiun-Yang Juang)

指導教授 ： 廖勇柏

中山醫學大學/健康管理學院/公共衛生學系碩士班/碩士(2013年)

https://doi.org/10.6834/CSMU.2013.00219

摘要

研究目的：分析台灣2001-2010年低收入戶與非低收入戶癌症盛行率差異及相關性比較。

研究方法：數據的取得來自國家衛生研究院釋出的全民健康保險資料，台灣全民健康保險為強制納保，99％的居民都有納保，資料庫包含人口統計數據、所有的醫療照護資訊、支出費用、入保與退保時間。為了方便研究，國家衛生研究院從全民健保資料庫以系統性抽樣抽出具代表性的族群，本研究計算2001-2010年低收入戶與非低收入戶癌症盛行率差異，以邏輯斯迴歸估算貧窮罹患癌症的相關性。

結果：低收入戶與非低收入戶罹患癌症的盛行率差異從1.75%－1.90%，低收入戶癌症盛行率大部分比非低收入戶高，但在男性60歲以上，產生逆轉的現象，但無統計顯著。10年整體低收入戶（貧窮者）脫離貧窮會降低17.99％的癌症盛行率。調整年齡層、社會經濟狀態與年齡層的交互作用後，30-39歲男性、女性低收入戶罹患癌症的危險性為非低收入戶的2.61倍、1.36倍，40-49歲男性、女性低收入戶罹患癌症的危險性為非低收入戶的2.00倍、1.60倍， 50-59歲男性、女性低收入戶罹患癌症的危險性為非低收入戶的1.10倍、1.26倍，男性60-69歲、70歲以上低收入戶罹患癌症的危險性為非低收入戶的0.74倍、0.60倍，產生較低的危險性，但無顯著。男性社會經濟狀態與年齡層存在交互作用，但在女性沒有。

結論：癌症盛行率與貧窮之間有很強的關係，特別是在年輕族群，克服貧窮可有效降低癌症盛行率。

關鍵字

低收入戶 ； 非低收入戶 ； 癌症 ； 盛行率 ； 交互作用

並列摘要

Purpose：To find the differences in cancer prevalence between low and non-low income households in Taiwan from 2001 to 2010.

Method：The data were obtained from the NHIRD released by the National Health Research Institute (NHRI) in Taiwan. The National Health Insurance program finances compulsory universal health care for 99% of all of residents of Taiwan. The database contains demographic data, all health-care encounters, expenditure and dates of enrolment and withdrawal. To facilitate research, the NHRI randomly sampled a representative database of two million subjects enrolled in the National Health Insurance program by a systematic sampling method. This two-million sample was validated to be representative of the entire insured population as reported by the NHRI. Logistic regression was used to model the differences in cancer prevalence in low and non-low income households.

Results：The difference of prevalence of all cancer in non-low and low income households ranged from 1.75% to 1.90%. Generally speaking, people in low income status have higher prevalence of cancer. There was low cancer prevalence in men aged >60 years, but not reaching statistic significance. The cancer prevalence was reduced 17.99% when people shake off poverty from low income status. The OR for men and women aged 30-39 years with low income status were 2.61 and 1.36, respectively. For men and women aged 40-49 years with low income status, OR were 2.00 and 1.60, respectively. For men and women aged 50-59 years with low income status, OR were 1.10 and 1.26, respectively. For men aged 60-69 and ≧70 years in low income status, the OR were 0.74 and 0.60, but not reaching significance. There were interactions between age and social-economic status for men, but not women.

Conclusion：There were relatively strong associations between cancer prevalence and poverty in young people. There was great reduction in cancer prevalence when overcoming poverty.

並列關鍵字

low income households ； non low income households ； cancer ； prevalence ； interaction

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