Pineda M D, White E, Kristal A R, Taylor V
Cancer Prevention Research Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.
Int J Epidemiol. 2001 Oct;30(5):976-82. doi: 10.1093/ije/30.5.976.
This study examines whether acculturation of Asian American women, assessed by place of birth, is associated with survival after diagnosis of breast cancer. We hypothesized that environmental factors associated with acculturation, such as a high-fat diet, would result in a pattern of better survival for first-generation Asians compared with subsequent-generation Asian Americans.
Analyses compare survival among women of four ethnic groups (Chinese [n = 1842], Japanese [n = 3319], Filipino [n = 1598] and a random sample of Caucasians [n = 10,000]) who were diagnosed with primary invasive breast carcinoma in three Surveillance, Epidemiology, and End Results Program (SEER) regions (San Francisco/Oakland, Hawaii, Seattle/Puget Sound) between 1973 and 1994. Analyses by birthplace compare first-generation Asian immigrants with subsequent-generation Asian Americans of the same ethnicity. Analyses were based on the Cox proportional hazards model and adjusted for age at diagnosis, stage of disease, year of diagnosis, type of treatment, marital status, and SEER region.
Japanese women had significantly better survival than all other races, but there were no significant differences in survival between Chinese, Filipino, and Caucasian women. There were no significant differences in survival by place of birth within each Asian ethnic group, after adjustment for demographic characteristics, stage of disease, and treatment.
The findings do not support the hypothesis that acculturation of Asian American women is associated with decreased breast cancer survival.
本研究探讨以出生地评估的亚裔美国女性文化适应情况是否与乳腺癌诊断后的生存情况相关。我们假设，与文化适应相关的环境因素，如高脂饮食，会导致第一代亚洲女性比后代亚裔美国女性有更好的生存模式。
分析比较了1973年至1994年间在三个监测、流行病学和最终结果计划（SEER）地区（旧金山/奥克兰、夏威夷、西雅图/普吉特海湾）被诊断为原发性浸润性乳腺癌的四个种族女性（华裔[n = 1842]、日裔[n = 3319]、菲律宾裔[n = 1598]以及白人随机样本[n = 10000]）的生存情况。按出生地进行的分析将第一代亚洲移民与同种族的后代亚裔美国女性进行了比较。分析基于Cox比例风险模型，并根据诊断时的年龄、疾病阶段、诊断年份、治疗类型、婚姻状况和SEER地区进行了调整。
日本女性的生存率显著高于所有其他种族，但华裔、菲律宾裔和白人女性之间的生存率没有显著差异。在调整了人口统计学特征、疾病阶段和治疗后，每个亚洲种族群体内按出生地划分的生存率没有显著差异。
研究结果不支持亚裔美国女性文化适应与乳腺癌生存率降低相关的假设。
