Farley J H, Hines J F, Taylor R R, Carlson J W, Parker M F, Kost E R, Rogers S J, Harrison T A, Macri C I, Parham G P
Department of Gynecologic Oncology, Tripler Army Medical Center Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, 1 Jarrett White Road TAMC, HI 96859-5000, USA.
Cancer. 2001 Feb 15;91(4):869-73.
[corrected] It was the purpose of this study to investigate whether race is an independent prognostic factor in the survival of patients with cervical carcinoma in a health care system with minimal racial bias, and few barriers to access to care.
Records for patients with a diagnosis of invasive cervical carcinoma from 1988 to 1999 were obtained from the Automated Central Tumor Registry for the United States Military Health Care System. Clinical data including race, age at diagnosis, histology, grade, stage, socioeconomic status, treatment modality, and survival also were obtained. Survival analysis was performed with Kaplan-Meier survival curves.
One thousand five hundred fifty-three patients were obtained for review. Sixty-five percent of patients were Caucasian, and 35% were minorities. Of the minorities, 29% were African Americans (AAs). Mean age of diagnosis was similar among AAs and Caucasians, 44 and 42 years, respectively. There was no statistically significant difference between the distribution of age, stage, grade, or histology between Caucasians and AAs. Forty-six percent of patients were treated with surgery and 56% with radiation therapy, with no difference in type of treatment between the Caucasian and AA groups. Five- and 10-year survival rates for Caucasians and AAs were 75%, and 76%, and 64% 65% (P = 0.59), respectively.
In an equal access, unbiased, nonracial environment, race is not an independent predictor of survival for patients with cervical carcinoma. This study has shown, for the first time to the authors' knowledge, that when they receive equal treatment for cervical carcinoma, AA women's survival can approach that of their nonminority counterparts (75% at 10 years).
[已修正]本研究旨在调查在一个种族偏见极小且就医障碍极少的医疗保健系统中，种族是否为宫颈癌患者生存的独立预后因素。
从美国军事医疗系统自动中央肿瘤登记处获取1988年至1999年诊断为浸润性宫颈癌患者的记录。还获取了包括种族、诊断时年龄、组织学、分级、分期、社会经济状况、治疗方式和生存情况在内的临床数据。采用Kaplan-Meier生存曲线进行生存分析。
共获取1553例患者的资料以供审查。65%的患者为白种人，35%为少数族裔。在少数族裔中，29%为非裔美国人（AA）。非裔美国人和白种人的平均诊断年龄相似，分别为44岁和42岁。白种人和非裔美国人在年龄、分期、分级或组织学分布上无统计学显著差异。46%的患者接受了手术治疗，56%接受了放射治疗，白种人和非裔美国人群体的治疗类型无差异。白种人和非裔美国人的5年和10年生存率分别为75%、76%以及64%、65%（P = 0.59）。
在平等就医、无偏见、非种族的环境中，种族并非宫颈癌患者生存的独立预测因素。据作者所知，本研究首次表明，当非裔美国女性宫颈癌患者接受平等治疗时，其生存率可接近非少数族裔女性（10年生存率为75%）。
