Douglas Nicholas M, Dockerty John D
Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
J Paediatr Child Health. 2007 Mar;43(3):173-7. doi: 10.1111/j.1440-1754.2007.01038.x.
This study aimed to assess survival by ethnicity for all New Zealand children (0-14 years) diagnosed with cancer during 1990-1993 and second, to determine the accuracy of the children's routinely collected ethnicity information.
Four hundred and nine children were followed up using two largely independent sources. We compared survival using the Cox model.
Maori and Pacific Island children had the same survival as non-Maori/non-Pacific children for 'all cancers combined' (hazard ratios (HR): 0.98; 95% confidence interval (CI): 0.64-1.50 and 1.01; 95% CI: 0.53-1.89 respectively) and acute lymphoblastic leukaemia (HR: 1.09; 95% CI: 0.45-2.62 and 0.99; 95% CI: 0.24-4.16, respectively). The ethnicity data stored within the National Health Index and the New Zealand Cancer Registry showed reasonably close agreement with ethnicity data provided by the children's mothers at interview (Kappa statistics: 0.82 and 0.81 respectively) while the Mortality Collection showed only moderate agreement (Kappa statistic: 0.63).
The point estimates in this study provide no evidence of ethnic disparities in survival from childhood cancer in New Zealand. However, even in this national study there were small numbers of Maori and Pacific children leading to wide confidence intervals. We therefore recommend cautious interpretation.
本研究旨在评估1990 - 1993年期间新西兰所有确诊患癌儿童(0 - 14岁)按种族划分的生存率,其次,确定常规收集的儿童种族信息的准确性。
使用两个基本独立的来源对409名儿童进行随访。我们使用Cox模型比较生存率。
对于“所有癌症合并”情况,毛利族和太平洋岛民儿童的生存率与非毛利/非太平洋岛民儿童相同(风险比(HR):分别为0.98;95%置信区间(CI):0.64 - 1.50和1.01;95% CI:0.53 - 1.89)以及急性淋巴细胞白血病(HR:分别为1.09;95% CI:0.45 - 2.62和0.99;95% CI:0.24 - 4.16)。存储在国家健康指数和新西兰癌症登记处的种族数据与儿童母亲在访谈时提供的种族数据显示出相当接近的一致性(卡帕统计量:分别为0.82和0.81),而死亡率收集数据仅显示出中等程度的一致性(卡帕统计量:0.63)。
本研究中的点估计没有提供新西兰儿童癌症生存率存在种族差异的证据。然而,即使在这项全国性研究中,毛利族和太平洋岛民儿童数量较少,导致置信区间较宽。因此,我们建议谨慎解读。