Cárdenas-Turanzas Marylou, Cooksley Catherine, Pettaway Curtis A, Sabichi Anita, Grossman H Barton, Elting Linda
Section of Health Services Research, Department of Biostatistics and Applied Mathematics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030-4009, USA.
Obstet Gynecol. 2006 Jul;108(1):169-75. doi: 10.1097/01.AOG.0000223885.25192.91.
To compare the survival of women and men with transitional cell bladder cancer.
We used the Surveillance Epidemiology and End Results database to identify patients aged 35 years or older diagnosed with bladder cancer between 1991 and 2001 actively followed up. We excluded cases diagnosed by autopsy or death certificates and those of unknown race. We used Cox proportional hazard regression to analyze survival in patients with advanced disease.
Of the 31,009 patients meeting eligibility criteria, 26.7% were women. Median age at diagnosis for women and men was 72 and 70 years, respectively. Regional disease was diagnosed in 20.3% of white women and 35.5% of African-American women, compared with only 17.6% of white men and 25.9% of African-American men (P < .001). Increased age, African-American race, and being female significantly increased the hazard of death (hazard ratio [HR] 1.037, 95% confidence interval [CI] 1,034-1.041; HR 1.402, 95% CI 1.187-1.656; and HR 1.842, 95% CI 1.158-2.931).
Women with bladder cancer, particularly African-Americans, have shorter survival. This is partially explained by higher risk of diagnosis with poorly differentiated tumors, advanced stage, and advanced age. Women should be targeted for timely diagnosis.
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比较移行细胞膀胱癌女性和男性患者的生存率。
我们使用监测、流行病学和最终结果数据库，识别1991年至2001年间确诊为膀胱癌且年龄在35岁及以上并接受积极随访的患者。我们排除了通过尸检或死亡证明诊断的病例以及种族不明的病例。我们使用Cox比例风险回归分析晚期疾病患者的生存率。
在符合入选标准的31,009例患者中，26.7%为女性。女性和男性的诊断中位年龄分别为72岁和70岁。20.3%的白人女性和35.5%的非裔美国女性被诊断为局部疾病，相比之下，只有17.6%的白人男性和25.9%的非裔美国男性（P <.001）。年龄增加、非裔美国人种族和女性显著增加死亡风险（风险比[HR] 1.037，95%置信区间[CI] 1.034 - 1.041；HR 1.402，95% CI 1.187 - 1.656；以及HR 1.842，95% CI 1.158 - 2.931）。
膀胱癌女性患者，尤其是非裔美国人，生存率较低。这部分是由于诊断为低分化肿瘤、晚期和高龄的风险较高。应针对女性进行及时诊断。
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