Jim Crow and estrogen-receptor-negative breast cancer: US-born black and white non-Hispanic women, 1992-2012
Jim Crow and estrogen-receptor-negative breast cancer: US-born black and white non-Hispanic women, 1992-2012
复制标题
DOI：
10.1007/s10552-016-0834-2
复制
发表时间：
2017-01-01
影响因子：
2.3
通讯作者：
Waterman, Pamela D.
中科院分区：
文献类型：
--
作者：
Krieger, Nancy;Jahn, Jaquelyn L.;Waterman, Pamela D.
目前还不清楚吉姆·克劳是否，美国21个州和哥伦比亚特区实行的法律的种族歧视，1964年被美国民权法案宣布为非法，影响着美国的癌症结果。我们假设吉姆·克劳出生地与美国黑人女性中雌激素受体阴性（ER-）乳腺肿瘤的高风险相关，但与白色女性无关，并且黑人女性比白色女性ER-肿瘤的风险更高。（不包括阿拉斯加）47,157名美国出生的黑人非西班牙裔妇女和348,514名美国出生的白色非西班牙裔妇女，年龄在25-84岁之间，在1992年1月1日至2012年12月31日期间被诊断为原发性浸润性乳腺癌。吉姆·克劳出生地仅在黑人而非白色女性中与ER-乳腺癌的几率增加相关，对1965年以前出生的女性影响最大。在黑人女性中，比较在吉姆·克劳州出生的女性与非吉姆·克劳州出生的女性，ER肿瘤的比值比（OR）为1.09（95%置信区间[CI] 1.06，1.13），与比较最差与最好人口普查区社会经济五分位数的女性的OR（1.15; 95% CI 1.07，1.23）相当。黑人与白色相比，ER-的OR在吉姆·克劳州出生的妇女中高于非吉姆·克劳州出生的妇女（1.41 [95% CI 1.13，1.46] vs. 1.27 [95% CI 1.24，1.31]）。美国黑人妇女乳腺癌ER状态的独特吉姆·克劳效应强调了为什么种族/民族不平等的分析必须历史背景化。
It is unknown whether Jim Crow-i.e., legal racial discrimination practiced by 21 US states and the District of Columbia and outlawed by the US Civil Rights Act in 1964-affects US cancer outcomes. We hypothesized that Jim Crow birthplace would be associated with higher risk of estrogen-receptor-negative (ER-) breast tumors among US black, but not white, women and also a higher black versus white risk for ER- tumors.We analyzed data from the SEER 13 registry group (excluding Alaska) for 47,157 US-born black non-Hispanic and 348,514 US-born white non-Hispanic women, aged 25-84 inclusive, diagnosed with primary invasive breast cancer between 1 January 1992 and 31 December 2012.Jim Crow birthplace was associated with increased odds of ER- breast cancer only among the black, not white women, with the effect strongest for women born before 1965. Among black women, the odds ratio (OR) for an ER- tumor, comparing women born in a Jim Crow versus not Jim Crow state, equaled 1.09 (95% confidence interval [CI] 1.06, 1.13), on par with the OR comparing women in the worst versus best census tract socioeconomic quintiles (1.15; 95% CI 1.07, 1.23). The black versus white OR for ER- was higher among women born in Jim Crow versus non-Jim Crow states (1.41 [95% CI 1.13, 1.46] vs. 1.27 [95% CI 1.24, 1.31]).The unique Jim Crow effect for US black women for breast cancer ER status underscores why analysis of racial/ethnic inequities must be historically contextualized.