Sex and Racial Differences in Bladder Cancer Presentation and Mortality in the US
Sex and Racial Differences in Bladder Cancer Presentation and Mortality in the US
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DOI：
10.1002/cncr.23986
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发表时间：
2009-01-01
期刊：
影响因子：
6.2
通讯作者：
Messing, Edward
中科院分区：
文献类型：
--
作者：
Scosyrev, Emil;Noyes, Katia;Messing, Edward
性别、种族和诊断时的年龄对膀胱癌 (BC) 的死亡率有显着影响。女性、非裔美国人和老年人的死亡率都较高。就诊时的肿瘤分级、分期和组织学类型也会影响结果。为了确定年龄和肿瘤特征是否单独解释了在某些人口群体中观察到的 BC 死亡风险过高，作者查询了监测、流行病学和最终结果 (SEER) 有限使用数据库，以了解 1990 年至 2005 年间 BC 的表现和结果。 方法：通过分级、分期和组织学类型来表征肿瘤。使用分段 Cox 回归模型按种族和性别比较 BC 特异性死亡率的危险率，并调整比较组之间显着差异的因素（年龄、分期、分级和组织学类型）。结果：在女性的前 2 至 3 年随访期间以及非洲裔美国人的前 4 年随访期间，存在 BC 死亡的过高风险。对年龄和肿瘤特征进行调整，消除了白人性别比较中约 30% 的过度风险。在黑人之间的性别比较和每个性别内部的种族比较中，大约50%到70%的超额危险可以通过调整消除。结论：肿瘤特征和就诊年龄的显着差异并不能完全解释女性和非裔美国人因 BC 死亡的过高风险。其他因素，例如治疗的选择和功效、给定肿瘤特征组内的差异和/或宿主因素，也可能发挥重要作用。癌症 2009；115：68-74。 (C) 2008 年美国癌症协会。
Sex, race, and age at diagnosis have a significant impact on mortality from bladder cancer (BC). Women, African Americans of both sexes, and the elderly, all experience higher mortality rates. Tumor grade, stage, and histologic type at presentation also affect outcome. To determine whether age and tumor characteristics alone explain the excess hazard of death from BC observed in some demographic groups, the authors queried the Surveillance, Epidemiology, and End Results (SEER) limited-use database for the presentations of and outcomes from BC between 1990 and 2005. METHODS: Tumors were characterized by grade, stage, and histologic type. Hazards rates for BC-specific mortality were compared by race and sex using a piecewise Cox regression model, adjusting for factors (age, stage, grade, and histologic type) that differed significantly between the groups that were compared. RESULTS: Excess hazard of death from BC was present during the first 2 to 3 years of follow-up among women and during the first 4 years of follow-up among African Americans. Adjustment for age and tumor characteristics eliminated approximately 30% of this excess hazard in sex comparison among whites. In sex comparison among blacks and in racial comparisons within each sex, approximately 50% to 70% of excess hazard could be eliminated by adjustment. CONCLUSIONS: Significant differences in tumor characteristics and age at presentation did not fully account for the excess hazard of death from BC among women and African Americans. Other factors, such as choice and efficacy of therapies, differences within a given tumor characteristic group, and/or host factors, also may play important roles. Cancer 2009;115:68-74. (C) 2008 American Cancer Society.