Disparities in breast cancer incidence across racial/ethnic strata and socioeconomic status: A systematic review
Disparities in breast cancer incidence across racial/ethnic strata and socioeconomic status: A systematic review
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DOI：
10.1016/s0027-9684(15)31378-x
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发表时间：
2008-07-01
影响因子：
3.3
通讯作者：
Vainshtein, Jeffrey
中科院分区：
文献类型：
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作者：
Vainshtein, Jeffrey
目的：与其他种族和较低社会经济地位(SES)的妇女相比，白人妇女和较高社会经济地位(SES)妇女的乳腺癌发病率较高。我们探索了SES的差异是否可以解释不同种族乳腺癌发病率的差异，方法：我们确定了1990至2007年间发表的几项研究，这些研究涉及不同种族和社会经济阶层乳腺癌发病率的差异。对于每项研究，我们计算了白人、黑人、西班牙裔和亚洲/太平洋岛民人群中SES最高层和最低层的乳腺癌发病率比率(IRR)。然后，我们使用这些IRR来比较不同种族和不同研究之间的SES和乳腺癌发病率的趋势。结果：我们确定的研究表明，不同种族之间乳腺癌发病率的差异程度随着SES的增加而减小。虽然基于人口普查区域的个体研究评估SES与乳腺癌发病率之间的相关性的方法没有确定种族之间的一致趋势，但调整了与SES密切相关的危险因素，消除了白人、西班牙裔和亚洲/太平洋岛民女性乳腺癌发病率的统计差异，但不是黑人。结论：我们发现，白人、西班牙裔和亚洲/太平洋岛民女性SES的种族差异可以很大程度上解释乳腺癌发病率的种族差异，但不能解释这些人群和黑人女性之间的差异。我们进一步强调了以前发表的研究之间在方法上的重要差异，这可能解释了他们不同的发现。
Objectives: A higher incidence of breast cancer has been reported both in white women and women of higher socioeconomic status (SES) compared to women of other races and lower SES, respectively. We explored whether differences in SES can account for disparities in breast cancer incidence between races,Methods: We identified several studies published between 1990 and 2007 that addressed disparities in breast cancer incidence across racial and socioeconomic strata. For each study, we calculated incidence rate ratios (IRRs) for breast cancer incidence in the highest strata to lowest strata of SES for white, black, Hispanic and Asian/Facific-Islander populations. We then used these IRRs to compare trends in SES and breast cancer incidence between races and across studies.Results: The studies we identified revealed that the magnitude of the disparity in breast cancer incidence between races decreases with increasing SES. While individual census-tract based studies' methods of assessing the association between SES and breast cancer incidence did not identify consistent trends between races, adjustment for risk factors closely correlated with SES eliminated the statistical differences in breast cancer incidence between women of white, Hispanic and Asian/Pacific-Islander, but not black, ethnicity.Conclusion: We found that racial differences in breast cancer incidence can largely be accounted for by ethnic differences in SES among white, Hispanic and Asian/Pacific-Islander women, but not between these populations and black women. We further highlight important differences in methodology between previously published studies that may account for their disparate findings.