Ethnic disparities in adherence to breast cancer survivorship surveillance care.
Ethnic disparities in adherence to breast cancer survivorship surveillance care.
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DOI：
10.1002/cncr.28490
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发表时间：
2014-03-15
期刊：
影响因子：
6.2
通讯作者：
Brewster, Abenaa M.
中科院分区：
文献类型：
--
作者：
Advani, Pragati S.;Ying, Jun;Theriault, Richard;Melhem-Bertrand, Amal;Moulder, Stacy;Bedrosian, Isabelle;Tereffe, Welela;Black, Shon;Pini, Tunghi May;Brewster, Abenaa M.
坚持监测、乳房X光检查和临床就诊指南是乳腺癌生存护理的重要组成部分。确定遵从性方面的种族差异可能会改善护理提供和结果。我们评估了1997年1月至2006年12月期间在我们癌症中心接受治疗的4535名I、II或III期乳腺癌患者的记录。我们使用广义估计方程和COX比例风险分析来评估种族差异在漏诊的乳房X光检查和临床随访长达4年，以及这些差异对总存活率的影响。不遵守乳房X光检查指南(P=.0002)和诊所就诊(P<；.0001)的情况随着时间的推移而增加。与白人患者相比，拉美裔和黑人患者更容易不遵守乳房X光检查指南(OR=1.35，95%可信区间[CI]=1.10~1.65，OR=1.36，95%CI=1.11~1.66)和就诊指南(OR=1.62，95%CI=1.27~2.06，OR=1.45，95%CI=1.13~1.86)。在不遵守乳房X光检查指南的情况下，西班牙裔种族和内分泌治疗之间存在交互作用(P=.001)。不遵守乳房X光检查和临床就诊指南与总存活率无关。随着时间的推移，退出乳腺癌生存护理的人数增加，黑人和西班牙裔患者更有可能不遵守规定。需要了解种族差异的原因，遵守乳房X光检查和临床就诊指南，以提高生存护理的保留率。
Adherence to guidelines for surveillance mammography and clinic visits is an important component of breast cancer survivorship care. Identifying ethnic disparities in adherence may lead to improved care delivery and outcomes. We evaluated records of 4,535 patients treated for stage I, II, or III breast cancer at our cancer center between January 1997 and December 2006. We used generalized estimating equations and Cox proportional hazards analyses to evaluate ethnic differences in missed mammograms and clinic visits up to 4 years of follow-up and the impact of those differences on overall survival. Nonadherence to guidelines for mammography (P = .0002) and clinic visits (P < .0001) increased over time. Hispanic and black patients were more likely to be nonadherent to guidelines for mammography (odds ratio [OR] = 1.35, 95% confidence interval [CI] = 1.10 to 1.65], OR = 1.36, 95% CI = 1.11 to 1.66, respectively) and clinic visits (OR = 1.62, 95% CI = 1.27 to 2.06, OR = 1.45, 95% CI = 1.13 to 1.86, respectively) than white patients. There was an interaction between Hispanic ethnicity and endocrine therapy on nonadherence to mammography guidelines (P = .001). Nonadherence to mammography and clinic visit guidelines was not associated with overall survival. Withdrawal from breast cancer survivorship care increases over time, and black and Hispanic patients are more likely to be nonadherent. An understanding of the reasons for ethnic disparities in adherence to guidelines for mammography and clinic visits is needed to improve retention in survivorship care.
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DOI：
10.1007/s11764-009-0107-0
发表时间：
2010-03
期刊：
Journal of cancer survivorship : research and practice
影响因子：
--
作者：
Carcaise-Edinboro P;Bradley CJ;Dahman B
通讯作者：
Dahman B
影响因子：
3.7
作者：
Breslau, Erica S.;Jeffery, Diana D.;Hawley, Sarah
通讯作者：
Hawley, Sarah
影响因子：
12.7
作者：
Borrell, Luisa N.;Lancet, Elizabeth A.
通讯作者：
Lancet, Elizabeth A.
影响因子：
45.3
作者：
Litton, Jennifer K.;Gonzalez-Angulo, Ana M.;Brewster, Abenaa M.
通讯作者：
Brewster, Abenaa M.
影响因子：
45.3
作者：
Hershman, Dawn L.;Kushi, Lawrence H.;Neugut, Alfred I.
通讯作者：
Neugut, Alfred I.