Oakley-Girvan Ingrid, Kolonel Laurence N, Gallagher Richard P, Wu Anna H, Felberg Anna, Whittemore Alice S
Stanford University School of Medicine, Stanford, California 94305-5405, USA.
Am J Public Health. 2003 Oct;93(10):1753-9. doi: 10.2105/ajph.93.10.1753.
We evaluated the effects of socioeconomic status and comorbidity on stage of disease and survival among 1509 population-based prostate cancer patients.
We applied logistic regression and Cox proportional hazards regression to data from Whites, African Americans, and Asian Americans who were diagnosed from 1987 to 1991.
Patients with existing comorbid conditions were less likely than those without these conditions to be diagnosed with advanced cancer. Compared with Whites, African Americans (odds ratio [OR] = 1.5; 95% confidence interval [CI] = 1.1, 2.2) and foreign-born Asian Americans (OR = 1.6; 95% CI = 1.0, 2.4) were more likely to be diagnosed with advanced cancer. Among men with localized disease, prostate cancer death rates were higher for African Americans than for Whites (death rate ratio = 2.3; 95% CI = 1.2, 4.7).
These findings support the need for further investigation of factors that affect access to and use of health care among African Americans and Asian Americans.
我们评估了社会经济地位和合并症对1509名基于人群的前列腺癌患者的疾病分期和生存情况的影响。
我们对1987年至1991年期间诊断出的白人、非裔美国人和亚裔美国人的数据应用了逻辑回归和Cox比例风险回归。
患有合并症的患者比没有这些合并症的患者被诊断为晚期癌症的可能性更小。与白人相比，非裔美国人（优势比[OR]=1.5；95%置信区间[CI]=1.1,2.2）和出生在国外的亚裔美国人（OR=1.6；95%CI=1.0,2.4）被诊断为晚期癌症的可能性更大。在患有局限性疾病的男性中，非裔美国人的前列腺癌死亡率高于白人（死亡率比=2.3；95%CI=1.2,4.7）。
这些发现支持需要进一步调查影响非裔美国人和亚裔美国人获得和使用医疗保健的因素。
