Racial/ethnic differences in survival among gastric cancer patients in california
Racial/ethnic differences in survival among gastric cancer patients in california
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DOI：
10.1007/s10552-019-01184-0
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发表时间：
2019-07-01
影响因子：
2.3
通讯作者：
Cress, Rosemary D.
中科院分区：
文献类型：
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作者：
Klapheke, Amy K.;Carvajal-Carmona, Luis G.;Cress, Rosemary D.
背景 胃癌是美国少数族裔死亡的重要原因。本研究的目的是调查人口统计和疾病亚组内胃癌患者生存率的种族差异。方法从加州癌症登记处确定 2006 年至 2015 年间诊断为浸润性上皮性胃癌的患者。 Cox 比例风险回归用于确定与非西班牙裔白人（NHW，n= 7,475）、非西班牙裔黑人（NHB，n=1,246）、西班牙裔（n= 6,274）和亚洲人/太平洋岛民（API，n= 4,204）生存相关的因素。在人口和疾病因素亚组内比较不同种族/民族的生存率。还计算了亚组内的五年相对生存率。结果 不同种族/民族的患者特征存在显着差异，但各组的生存预测因子相似。总体而言，API（HR = 0.83，95% CI：0.79、0.88，p < 0.0001）和西班牙裔（HR = 0.94，95% CI：0.90、0.99，p = 0.0104）的生存率高于 NHW，但 NHB 和 NHW 的预后没有差异（HR = 1.06， 95% CI：0.98，1.15，p = 0.2237）。 API 的生存优势在几乎所有人口和疾病亚组中都持续存在，但在大多数群体中，西班牙裔和 NHB 的生存率与 NHW 相似。对于有公共保险或没有保险的患者以及贲门肿瘤患者来说，种族并不是生存的重要预测因素。 结论 不同种族/民族的生存率存在一些差异，但种族/民族本身并不能解释胃癌的不同结果。未来的研究，特别是调查人群特异性病因和分子肿瘤谱的作用的研究，需要进一步了解与生存相关的因素。
Background Gastric cancer is an important cause of death among racial/ethnic minorities in the U.S. The objective of this study was to investigate racial disparities in survival among gastric cancer patients within demographic and disease subgroups.Methods Patients diagnosed with invasive epithelial gastric cancer between 2006 and 2015 were identified from the California Cancer Registry. Cox proportional hazards regression was used to identify factors associated with survival among non-Hispanic whites (NHWs, n= 7,475), non-Hispanic blacks (NHBs, n=1,246), Hispanics (n= 6,274), and Asians/Pacific Islanders (APIs, n= 4,204). Survival was compared across race/ethnicity within subgroups of demographic and disease factors. Five-year relative survival was also calculated within subgroups.Results There were notable differences in patient characteristics by race/ethnicity, but predictors of survival were similar for each group. Overall, APIs (HR = 0.83, 95% CI: 0.79, 0.88, p < 0.0001) and Hispanics (HR = 0.94, 95% CI: 0.90, 0.99, p = 0.0104) had better survival than NHWs, but NHBs and NHWs did not have different prognosis (HR = 1.06, 95% CI: 0.98, 1.15, p = 0.2237). The survival advantage of APIs persisted in nearly every demographic and disease subgroup, but Hispanics and NHBs had similar survival as NHWs in most groups. Race was not a significant predictor of survival among those with public or no insurance and patients with cardia tumors.Conclusions There are some differences in survival by race/ethnicity, but race/ethnicity alone cannot explain disparate outcomes in gastric cancer. Future studies, particularly ones that investigate the role of population-specific etiological factors and molecular tumor profiles, are needed to further understand factors associated with survival.