Differences in breast cancer stage, treatment, and survival by race and ethnicity
Differences in breast cancer stage, treatment, and survival by race and ethnicity
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DOI：
10.1001/archinte.163.1.49
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发表时间：
2003-01-13
影响因子：
--
通讯作者：
Daling, JR
中科院分区：
文献类型：
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作者：
Li, CI;Malone, KE;Daling, JR
背景：在美国，患有乳腺癌的黑人和西班牙裔白人女性的病情比非西班牙裔白人更晚期，存活率更低，而亚洲人和太平洋岛民则不是。然而，亚洲人、太平洋岛民和西班牙裔白人是不同的群体，很少有研究评估这些群体亚群的乳腺癌分期、治疗和死亡率。方法：利用参与监测、流行病学和最终结果计划的11个基于人群的肿瘤登记数据，我们进行了一项回溯性队列研究，以评估种族和民族与乳腺癌分期、治疗和死亡率的关系。在1992年1月1日至1998年12月31日期间，共有124934名女性被诊断患有首例浸润性乳腺癌，其中包括97999名非西班牙裔白人、10560名黑人、322名美国印第安人、8834名亚裔和太平洋岛民、7219名西班牙裔白人。结果：相对于非西班牙裔白人，黑人、美国印第安人、夏威夷人、印度人和巴基斯坦人、墨西哥人、南美人和中美洲人以及波多黎各人患IV期乳腺癌的风险增加了1.4到3.6倍。黑人、墨西哥人和波多黎各人接受或选择不符合2000年国家综合癌症网络标准的第一疗程手术和放射治疗的可能性要高出20%到50%。此外，黑人、美洲印第安人、夏威夷人、越南人、墨西哥人、南美和中美洲人以及波多黎各人在乳腺癌诊断后的死亡率要高出20%到200%。结论：不同种族和民族在乳腺癌分期、治疗和死亡率方面存在差异。通过靶向因素，特别是社会经济因素，这些差异可能会提高乳腺癌的存活率。
Background: in the United States, black and Hispanic white women with breast cancer present with more advanced stages and have poorer survival rates than non-Hispanic whites, whereas Asians and Pacific islanders do not. However, Asians and Pacific islanders and Hispanic whites are heterogeneous populations, and few studies have evaluated breast cancer stage, treatments, and mortality rates for subgroups of these populations.Methods: Using data from 11 population-based tumor registries that participate in the Surveillance, Epidemiology, and End Results Program, we conducted a retrospective cohort study to evaluate the relationship between race and ethnicity and breast cancer stage, treatments, and mortality rates. The cohort of 124934 women diagnosed as having a first primary invasive breast carcinoma between January 1, 1992, and December 31, 1998, included 97 999 non-Hispanic whites, 10 560 blacks, 322 American Indians, 8834 Asians and Pacific Islanders, and 7219 Hispanic whites.Results: Relative to non-Hispanic whites, blacks, American Indians, Hawaiians, Indians and Pakistanis, Mexicans, South and Central Americans, and Puerto Ricans had 1.4- to 3.6-fold greater risks of presenting with stage IV breast cancer. Blacks, Mexicans, and Puerto Ricans were 20% to 50% more likely to receive or elect a first course of surgical and radiation treatment not meeting the 2000 National Comprehensive Cancer Network standards. In addition, blacks, American Indians, Hawaiians, Vietnames, Mexicans, South and Central Americans, and Puerto Ricans had 20% to 200% greater risks of mortality after a breast cancer diagnosis.Conclusions: Differences in breast cancer stage, treatments, and mortality rates are present by race and ethnicity. Breast cancer survival may be improved by targeting factors, particularly socioeconomic factors, that underlie these differences.