Delays in breast cancer diagnosis and treatment by racial/ethnic group
Delays in breast cancer diagnosis and treatment by racial/ethnic group
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DOI：
10.1001/archinte.166.20.2244
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发表时间：
2006-11-13
影响因子：
--
通讯作者：
Smith, Suzanne J.
中科院分区：
文献类型：
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作者：
Sheinfeld Gorin, Sherri;Heck, Julia E.;Smith, Suzanne J.
背景资料：虽然白色妇女的乳腺癌发病率最高，非洲裔美国人，其次是西班牙裔，美洲印第安人/阿拉斯加原住民，亚裔美国人或太平洋岛民，妇女死于这种疾病的比率较高。及时开始治疗已被证明可以提高生存率，并可能有助于减少种族/种族groups.Methods之间的死亡率差异：本研究的目的是描述在不同的种族/种族群体的原发性乳腺癌的初步诊断和治疗的时间延迟。数据来自监测，流行病学和最终结果医疗保险数据库。在这项研究中的妇女被诊断为患有乳腺癌之间的1992年1月1日，1999年12月31日。使用门诊和住院就诊的账单报销。共有49865名65岁及以上的女性医疗保险接受者参加了这项研究。种族/民族群体进行了比较，在他们的诊断，治疗和临床延迟（即，妇女的诊断和治疗延迟）。结果：非洲裔美国妇女经历了最大的诊断，治疗和临床延迟。在控制了其他预测因素后，与白色女性相比，非洲裔美国女性的几率为1.39倍（95%置信区间，1.18-1.63）诊断延迟超过2个月，（95%置信区间，1.401.91）治疗延迟超过1个月，（95%置信区间，1.75-2.86）的组合临床延迟。在一项基于人群的研究中，非洲裔美国妇女在初次诊断和开始乳腺癌治疗方面经历了最多的延迟，相对于其他种族/民族亚组的女性。尽管索赔数据库存在局限性，但研究结果的幅度和方向在整个研究中是一致的，这表明减少这些延迟至关重要。
Background: Although white women have the highest incidence of breast cancer, African American, followed by Hispanic, American Indian/Alaskan Native, and Asian American or Pacific Islander, women have higher death rates from the disease. Timely initiation of treatment has been shown to improve survival, and may help to lessen the mortality differences among racial/ethnic groups.Methods: The purpose of this study was to describe time delays in the initial diagnosis and treatment of primary breast carcinoma across diverse ethnic/racial groups. Data are from the Surveillance, Epidemiology, and End Results Medicare database. Women in this study were diagnosed as having breast cancer between January 1, 1992, and December 31, 1999. Billing claims from outpatient and inpatient visits were used. A total of 49 865 female Medicare recipients 65 years and older were enrolled in the study. Racial/ethnic groups were compared in their diagnostic, treatment, and clinical delay (ie, women with a diagnostic and treatment delay).Results: African American women experienced the greatest diagnostic, treatment, and clinical delay. After controlling for other predictors, compared with white women, African American women had a 1.39-fold odds (95% confidence interval, 1.18-1.63) of diagnostic delay beyond 2 months, a 1.64-fold odds (95% confidence interval, 1.401.91) of treatment delay beyond 1 month, and a 2.24fold odds (95% confidence interval, 1.75-2.86) of having a combined clinical delay.Conclusions: In a population-based study, African American women experienced the most delays in initial diagnosis and initiation of breast cancer treatment, relative to women of other racial/ethnic subgroups. Despite the limitations of a claims database, the magnitude and direction of the findings are consistent across the research, suggesting the critical importance of reducing these delays.