Racial disparities in breast cancer mortality in a multiethnic cohort in the Southeast
Racial disparities in breast cancer mortality in a multiethnic cohort in the Southeast
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DOI：
10.1002/cncr.26570
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发表时间：
2012-05-15
期刊：
影响因子：
6.2
通讯作者：
Hebert, James R.
中科院分区：
文献类型：
--
作者：
Adams, Swann Arp;Butler, William M.;Hebert, James R.
背景：尽管已经做了很多工作来研究与非裔美国妇女死亡率较高相关的因素，但研究南卡罗来纳州农村非裔美国人之间差异的文献却很少。这项调查的目的是检查居住在南卡罗来纳州的一个大型队列中乳腺癌患者的种族和死亡率之间的关系，所有患者的治疗方案都是标准化的。方法：研究对象包括 2000 年至 2002 年间在当地一家设有综合乳腺中心的大型医院诊断患有乳腺癌的 1209 名女性。计算卡普兰-迈耶生存曲线以确定非洲裔美国和欧洲裔美国女性的生存率，并按疾病阶段或其他预后特征进行分层。调整各种特征后，使用 Cox 多变量生存模型来估计风险比 (HR)。结果：非裔美国女性的 5 年总体全因死亡率生存率与 78% 相似，与欧洲裔美国女性的 89% 相似，P < 0.01。在对具有相同疾病特征的女性亚群的分析中，非裔美国女性患同类型乳腺癌的死亡率显着高于欧洲裔美国女性。在多变量模型中，非裔美国女性的乳腺癌特异性死亡（HR，2.41；95% 置信区间 [CI]，1.21-4.79）和全因死亡率（HR，1.42；95% CI，1.06-1.89）的死亡率均显着高于欧洲裔美国女性。结论：即使在调整与疾病相关的预后特征后，居住在南卡罗来纳州农村的非裔美国女性的乳腺癌生存率较低。这些发现支持对非裔美国乳腺癌患者进行健康干预，旨在采取三级预防策略或在诊断时进一步降低疾病分期。癌症 2011。(c) 2011 美国癌症协会。
BACKGROUND: Although much has been done to examine those factors associated with higher mortality among African American women, there is a paucity of literature that examines disparities among rural African Americans in South Carolina. The purpose of this investigation was to examine the association of race and mortality among breast cancer patients in a large cohort residing in South Carolina for which treatment regimens are standardized for all patients. METHODS: Subjects included 1209 women diagnosed with breast cancer between 2000 and 2002 at a large, local hospital containing a comprehensive breast center. Kaplan-Meier survival curves were calculated to determine survival rates among African American and European American women, stratified by disease stage or other prognostic characteristics. Adjusting for various characteristics, Cox multivariate survival models were used to estimate the hazard ratio (HR). RESULTS: The 5-year overall all-cause mortality survival proportion was similar to 78% for African American women and similar to 89% for European American women, P < 0.01. In analyses of subpopulations of women with identical disease characteristics, African American women had significantly higher mortality than European American women for the same type of breast cancer disease. In multivariate models, African American women had significantly higher mortality than European American women for both breast cancer-specific death (HR, 2.41; 95% confidence interval [CI], 1.21-4.79) and all-cause mortality (HR, 1.42; 95% CI, 1.06-1.89). CONCLUSIONS: African American women residing in rural South Carolina had lower survival for breast cancer even after adjustment for disease-related prognostic characteristics. These findings support health interventions among African American breast cancer patients aimed at tertiary prevention strategies or further down-staging of disease at diagnosis. Cancer 2011. (c) 2011 American Cancer Society.