Impact of African-American race on presentation, treatment, and survival of head and neck cancer
Impact of African-American race on presentation, treatment, and survival of head and neck cancer
复制标题
DOI：
10.1016/j.oraloncology.2014.09.004
复制
发表时间：
2014-12-01
期刊：
影响因子：
4.8
通讯作者：
Chuang, Sung-Kiang
中科院分区：
文献类型：
--
作者：
Mahal, Brandon A.;Inverso, Gino;Chuang, Sung-Kiang
目的：为了确定非裔美国人的种族和阶段之间的关联在诊断，接受明确的治疗，癌症特异性死亡率之间的患者与头颈cancer.Materials和方法：监测，流行病学和最终结果（SEER）数据库被用来进行回顾性研究34,437例头颈癌患者从2007年至2010年。应用多变量逻辑回归分析确定种族对就诊时癌症分期（转移性vs.非转移性）和接受确定性治疗的影响。精细和灰色竞争风险回归模型之间的关联种族和头颈部cancer-specific mortality.Results：非裔美国人更容易出现转移性癌症相比，非裔美国人（调整比值比[AOR] 1.76; CI 1.50-2.07; P < 0.001）。在非转移性疾病患者中，非裔美国人接受确定性治疗的可能性较小（AOR 0.63; CI 0.55-0.72; P < 0.001）。在中位随访19个月后，发现非转移性疾病的非裔美国人有较高的头颈癌特异性死亡风险（AHR 1.19; 95% CI 1.09-1.29; P < 0.001）。患有头颈癌的非裔美国人更有可能出现转移性疾病，不太可能得到明确的治疗，更有可能死于头颈癌。这项研究中发现的令人无法接受的高差距率应作为紧急医疗保健政策干预的直接目标。(C)2014爱思唯尔有限公司版权所有。
Objectives: To determine the associations between African American race and stage at diagnosis, receipt of definitive therapy, and cancer-specific mortality among patients with head and neck cancer.Materials and methods: The Surveillance, Epidemiology and End Results (SEER) database was used to conduct a retrospective study on 34,437 patients diagnosed with head and neck cancer from 2007 to 2010. Multivariable logistic regression analyses were applied to determine the impact of race on cancer stage at presentation (metastatic vs. non-metastatic) and receipt of definitive treatment. Fine and Gray competing-risks regression modeled the association between race and head and neck cancer-specific mortality.Results: African Americans were more likely to present with metastatic cancer compared to non-African Americans (Adjusted Odds Ratio [AOR] 1.76; CI 1.50-2.07; P < 0.001). Among patients with non-metastatic disease, African Americans were less likely to receive definitive treatment (AOR 0.63; CI 0.55-0.72; P < 0.001). After a median follow-up of 19 months, African Americans with non-metastatic disease were found to have a higher risk of head and neck cancer specific mortality (AHR 1.19; 95% CI 1.09-1.29; P < 0.001).Conclusion: African Americans with head and neck cancer are more likely to present with metastatic disease, less likely to be treated definitively, and are more likely to die from head and neck cancer. The unacceptably high rates of disparity found in this study should serve as immediate targets for urgent healthcare policy intervention. (C) 2014 Elsevier Ltd. All rights reserved.