Racial disparities in breast cancer diagnosis and treatment by hormone receptor and HER2 status.
Racial disparities in breast cancer diagnosis and treatment by hormone receptor and HER2 status.
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DOI：
10.1158/1055-9965.epi-15-0293
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发表时间：
2015-11
期刊：
影响因子：
--
通讯作者：
Li CI
中科院分区：
文献类型：
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作者：
Chen L;Li CI
非裔美国人和西班牙裔女性更容易被诊断为侵袭性乳腺癌。不同亚型乳腺癌之间的差异还没有很好的文献记载。使用来自18个SEER癌症登记处的数据，我们确定了102,064名年龄在20岁或以上的女性，这些女性在2010-2011年被诊断为浸润性乳腺癌，并且已知分期、激素受体（HR）和HER2状态。根据HR/HER2状态评估种族/民族与癌症分期和接受指南一致性治疗之间的关系。总体而言，与非西班牙裔白人相比，非裔美国人和西班牙裔女性被诊断为II-IV期乳腺癌的可能性要高30-60%。在所有四种亚型中，非裔美国女性患四期乳腺癌的风险要高出40-70%。美国印第安人/阿拉斯加土著妇女患四期三阴性乳腺癌的风险高出3.9倍。非裔美国人和西班牙裔白人总体上和跨亚型接受非指南一致性乳腺癌治疗的可能性要高30-40%。一些种族/民族的妇女更有可能被诊断为晚期乳腺癌。非裔美国人和美洲印第安人/阿拉斯加土著妇女被诊断为IV期三阴性乳腺癌的风险最高。非裔美国人和西班牙裔妇女在不同亚型中也始终处于未接受指南一致治疗的较高风险。这些发现提供了乳腺癌亚型在分期和治疗上的种族/民族差异的重要特征。
African American and Hispanic women are more likely to be diagnosed with aggressive forms of breast cancer. Disparities within each subtype of breast cancer have not been well documented. Using data from 18 SEER cancer registries, we identified 102,064 women aged 20 years or older, diagnosed with invasive breast cancer in 2010–2011, and with known stage, hormone receptor (HR) and HER2 status. Associations between race/ethnicity and cancer stage and receipt of guideline concordant treatment were evaluated according to HR/HER2 status. Overall, African American and Hispanic women were 30–60% more likely to be diagnosed with stage II–IV breast cancer compared to Non-Hispanic whites. African American women had 40–70% higher risks of stage IV breast cancer across all four subtypes. American Indian/Alaska Native women had a 3.9-fold higher risk of stage IV triple negative breast cancer. African American and Hispanic whites were 30–40% more likely to receive non-guideline concordant treatment for breast cancer overall and across subtypes. Women in several racial/ethnic groups are more likely to be diagnosed with more advanced stage breast cancer. African American and American Indian/Alaska native women in particular had the highest risk of being diagnosed with stage IV triple negative breast cancer. African American and Hispanic women were also consistently at higher risk of not receiving guideline concordant treatment across subtypes. These findings provide important characterization of which subtypes of breast cancer racial/ethnic disparities in stage and treatment persist.