Barnholtz-Sloan Jill S, Tainsky Michael A, Abrams Judith, Severson Richard K, Qureshi Faisal, Jacques Suzanne M, Levin Nancy, Schwartz Ann G
Epidemiology Section, Population Studies and Prevention Program, Karmanos Cancer Institute, Detroit, Michigan 48201, USA.
Cancer. 2002 Mar 15;94(6):1886-93. doi: 10.1002/cncr.10415.
Ovarian carcinoma is the leading cause of death among all female reproductive malignancies. There are substantial differences in age-adjusted incidence rates and survival rates between Caucasian women and African-American women. The objective of this study was to examine ethnic differences in survival after ovarian carcinoma in a population-based sample of women.
Thirteen thousand eighty-three patients (12285 Caucasian women and 798 African-American women) who were diagnosed with primary ovarian carcinoma from the population-based Surveillance, Epidemiology, and End Results (SEER) Program were used for analysis. Odds ratios were used to estimate the association between prognostic variables and ethnicity. Chi-square tests were used to determine the statistical significance of these associations (using two-sided P values). Univariable and multivariable Cox proportional hazards models were used to assess survival differences.
African-American women were significantly younger at the time of diagnosis, were more likely to be single, and were less likely to undergo site specific surgery compared with Caucasian women. In addition, the crude median survival for African-American women was nearly 1 year less than for Caucasian women (22 months vs. 32 months, respectively; P < 0.0001). African-American women were at a 30% increased risk of death from any cause when adjusting for all other prognostic variables that differed between the two ethnic groups.
African-American women who are diagnosed with ovarian carcinoma are at a significant increased risk of death from any cause compared with Caucasian women who are diagnosed with ovarian carcinoma.
卵巢癌是所有女性生殖系统恶性肿瘤中导致死亡的主要原因。白种女性和非裔美国女性在年龄调整发病率和生存率方面存在显著差异。本研究的目的是在基于人群的女性样本中，研究卵巢癌患者生存情况的种族差异。
从基于人群的监测、流行病学和最终结果（SEER）项目中选取13083例被诊断为原发性卵巢癌的患者（12285例白种女性和798例非裔美国女性）进行分析。采用比值比来估计预后变量与种族之间的关联。使用卡方检验来确定这些关联的统计学显著性（使用双侧P值）。采用单变量和多变量Cox比例风险模型来评估生存差异。
与白种女性相比，非裔美国女性在诊断时明显更年轻，更可能单身，且接受特定部位手术的可能性更小。此外，非裔美国女性的粗略中位生存期比白种女性短近1年（分别为22个月和32个月；P < 0.0001）。在对两个种族之间存在差异的所有其他预后变量进行调整后，非裔美国女性因任何原因死亡的风险增加了30%。
与被诊断为卵巢癌的白种女性相比，被诊断为卵巢癌的非裔美国女性因任何原因死亡的风险显著增加。
