Analysis of racial differences in incidence, survival, and mortality for malignant tumors of the uterine corpus
Analysis of racial differences in incidence, survival, and mortality for malignant tumors of the uterine corpus
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DOI：
10.1002/cncr.11484
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发表时间：
2003-07-01
期刊：
影响因子：
6.2
通讯作者：
Devesa, SS
中科院分区：
文献类型：
--
作者：
Sherman, ME;Devesa, SS
背景。在美国，黑人子宫体恶性肿瘤的发病率低于白人，而黑人的死亡率却高于白人。黑人死亡率较高的原因一直存在争议。使用来自监测、流行病学和最终结果项目的数据，作者比较了1992-1998年期间西班牙裔白人、黑人和非西班牙裔白人患者子宫体（包括子宫，未另行说明）恶性肿瘤的组织病理类型的发病率。作者还根据组织病理类型和其他因素比较了黑人和白人的累积相对存活率，并计算了估计的类型特异性死亡率。与非西班牙裔白人（23.43,95% CI, 23.06-23.81）相比，西班牙裔白人（14.04,95%可信区间[CI]， 13.39-14.72）和黑人（15.31,95% CI, 14.61-16.04）的体恶性肿瘤总发病率（每10万女性年）显著低于西班牙裔白人（23.43,95% CI, 23.06-23.81）。与非西班牙裔白人相比，黑人浆液/透明细胞癌（比率比，1.85;95% CI, 1.61-2.12）、癌肉瘤（比率比，2.33;95% CI, 1.99-2.72）和肉瘤（比率比，1.56;95% CI, 1.31-1.86）的发病率显著高于白人。根据分期、分级和年龄分层，在每一种组织病理学类别和“常规”类型的子宫内膜腺癌中，黑人的生存率都比白人差。罕见侵袭性肿瘤占黑人死亡率的53%，而白人为36%。通常类型的子宫内膜腺癌和罕见的侵袭性肿瘤的预后不佳，同样导致黑人妇女因体癌而相对较高的死亡率。癌症2003;98:176 - 86。2003年由美国癌症协会出版。
BACKGROUND. In the United States, incidence rates for malignant tumors of the uterine corpus are lower among blacks than among whites, whereas mortality rates are higher among blacks. Reasons for the higher level of mortality among blacks have been debated.METHODS. Using data from the Surveillance, Epidemiology, and End Results program, the authors compared incidence rates by histopathologic type for malignant tumors of the uterine corpus (including uterus, not otherwise specified) during the period 1992-1998 among white Hispanic, black, and white non-Hispanic patients. The authors also compared cumulative relative survival rates for blacks and whites by histopathologic type and by other factors, and they calculated estimated type-specific mortality rates.RESULTS. Overall incidence (per 100,000 woman-years) of corpus malignancy was significantly lower among white Hispanics (14.04; 95% confidence interval [CI], 13.39-14.72) and blacks (15.31; 95% CI, 14.61-16.04) compared with white nonHispanics (23.43; 95% CI, 23.06-23.81). Compared with white non-Hispanics, blacks had significantly higher incidence rates of serous/clear cell carcinoma (rate ratio, 1.85; 95% CI, 1.61-2.12), carcinosarcoma (rate ratio, 2.33; 95% CI, 1.99-2.72), and sarcoma (rate ratio, 1.56; 95% CI, 1.31-1.86). Survival was worse for blacks than for whites in every histopathologic category and in 'usual' types of endometrial adenocarcinoma, stratified by stage, grade, and age. Rare aggressive tumor types accounted for 53% of mortality among blacks, compared with 36% among whites.CONCLUSIONS. Less favorable outcomes for usual types of endometrial adenocarcinoma and for rare aggressive tumors contribute equally to the relatively high mortality due to corpus cancer among black women. Cancer 2003;98:176-86. Published 2003 by the American Cancer Sociery.