Breast Cancer Mortality Hot Spots Among Black Women With de Novo Metastatic Breast Cancer.
Breast Cancer Mortality Hot Spots Among Black Women With de Novo Metastatic Breast Cancer.
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DOI：
10.1093/jncics/pkaa086
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发表时间：
2021-03
影响因子：
4.4
通讯作者：
Moore JX
中科院分区：
文献类型：
--
作者：
Han Y;Langston M;Fuzzell L;Khan S;Lewis-Thames MW;Colditz GA;Moore JX
居住在南部各州的黑人女性的乳腺癌死亡率是美国最高的。新发转移性乳腺癌预后较差。鉴于这些死亡率，我们首次将具有全国代表性的乳腺癌死亡率热点地区(乳腺癌死亡率较高的县)的数据与美国的癌症死亡率数据联系起来，并调查了黑人女性中地理乳腺癌死亡率热点与转移性乳腺癌死亡率的关系。我们在监测、流行病学和最终结果(SEER)中确定了7292名被诊断为新发转移性乳腺癌的黑人女性。县级特征是从2014年县健康排名中获得的，并与SEER联系在一起。我们使用COX比例风险模型来计算热点和非热点县之间死亡率的调整危险比(AHRS)和95%可信区间(CI)。在7292例患者中，有393例(5.4%)居住在乳腺癌死亡热点地区。在调整了个体和肿瘤水平的因素和治疗后，居住在热点地区的妇女与居住在非热点地区的妇女相比，乳腺癌特异性死亡率(AHR=0.99，95%CI=0.85~1.15)和全因死亡率(AHR=0.97，95%CI=0.84~1.11)的风险相似。对县级特征的额外调整不会影响死亡率。在黑人女性中，生活在乳腺癌死亡热点地区与新发转移性乳腺癌死亡率无关。未来的研究应该开始检查个体和群体水平的决定因素以及分子和遗传决定因素的变异，这些决定因素是转移性乳腺癌侵袭性的基础。
Black women living in southern states have the highest breast cancer mortality rate in the United States. The prognosis of de novo metastatic breast cancer is poor. Given these mortality rates, we are the first to link nationally representative data on breast cancer mortality hot spots (counties with high breast cancer mortality rates) with cancer mortality data in the United States and investigate the association of geographic breast cancer mortality hot spots with de novo metastatic breast cancer mortality among Black women. We identified 7292 Black women diagnosed with de novo metastatic breast cancer in Surveillance, Epidemiology, and End Results (SEER). The county-level characteristics were obtained from 2014 County Health Rankings and linked to SEER. We used Cox proportional hazards models to calculate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for mortality between hot spot and non–hot spot counties. Among 7292 patients, 393 (5.4%) resided in breast cancer mortality hot spots. Women residing in hot spots had similar risks of breast cancer–specific mortality (aHR = 0.99, 95% CI = 0.85 to 1.15) and all-cause mortality (aHR = 0.97, 95% CI = 0.84 to 1.11) as women in non–hot spots after adjusting for individual and tumor-level factors and treatments. Additional adjustment for county-level characteristics did not impact mortality. Living in a breast cancer mortality hot spot was not associated with de novo metastatic breast cancer mortality among Black women. Future research should begin to examine variation in both individual and population-level determinants, as well as in molecular and genetic determinants that underlie the aggressive nature of de novo metastatic breast cancer.
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影响因子：
3.4
作者：
Chien LC;Yu HL;Schootman M
通讯作者：
Schootman M
影响因子：
8.8
作者：
Moore JX;Donnelly JP;Griffin R;Howard G;Safford MM;Wang HE
通讯作者：
Wang HE
影响因子：
254.7
作者：
DeSantis, Carol E.;Fedewa, Stacey A.;Jemal, Ahmedin
通讯作者：
Jemal, Ahmedin
影响因子：
3.6
作者：
ANSELIN, L
通讯作者：
ANSELIN, L
DOI：
10.1158/1055-9965.epi-16-0889
发表时间：
2017-06
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Mariotto AB;Etzioni R;Hurlbert M;Penberthy L;Mayer M
通讯作者：
Mayer M