Smith Emily Rose, Adams Swann Arp, Das Irene Prabhu, Bottai Matteo, Fulton Jeanette, Hebert James R
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, USA.
Cancer Epidemiol Biomarkers Prev. 2008 Oct;17(10):2882-90. doi: 10.1158/1055-9965.EPI-08-0221. Epub 2008 Oct 3.
Breast cancer affects thousands each year in the United States, and disproportionately affects certain subgroups. For example, the incidence of breast cancer in South Carolina is lower in African American compared with European American women by approximately 12% to 15%, but their mortality rate is twice as high as in European American women. The purpose of the study was to assess factors associated with breast cancer mortality between African American and European American women. Participants (n=314) in South Carolina's Breast and Cervical Cancer Early Detection Program (SCBCCEDP), which provides breast cancer screening and treatment services, during the years 1996-2004 were included in the study. Data, including tumor characteristics, delay intervals, and race, were examined using the chi(2) test and the Wilcoxon rank-sum test. Cox regression modeling was used to assess the relationship between delay intervals and other factors. No racial differences were found in age at diagnosis, tumor characteristics, or delay intervals. Time delay intervals did not explain differences and mortality rates by race. Survival, however, was affected by prognostic factors as well as by a significant interaction between hormone-receptor status and race. Despite the excellent record of the SCBCCEDP in screening and diagnostic or treatment referrals, the racial disparities in breast cancer mortality continue to exist in South Carolina. These findings highlight the need for future research into the etiology of racial differences, and their impact on breast cancer survival.
在美国，每年有数千人受到乳腺癌的影响，而且某些亚群体受到的影响尤为严重。例如，南卡罗来纳州非裔美国女性的乳腺癌发病率比欧裔美国女性低约12%至15%，但其死亡率却是欧裔美国女性的两倍。这项研究的目的是评估非裔美国女性和欧裔美国女性中与乳腺癌死亡率相关的因素。参与南卡罗来纳州乳腺癌和宫颈癌早期检测项目（SCBCCEDP）的1996年至2004年间的参与者（n = 314）被纳入该研究，该项目提供乳腺癌筛查和治疗服务。使用卡方检验和Wilcoxon秩和检验对包括肿瘤特征、延迟间隔和种族在内的数据进行了检查。Cox回归模型用于评估延迟间隔与其他因素之间的关系。在诊断年龄、肿瘤特征或延迟间隔方面未发现种族差异。时间延迟间隔并不能解释种族之间的差异和死亡率。然而，生存率受到预后因素以及激素受体状态与种族之间显著相互作用的影响。尽管SCBCCEDP在筛查以及诊断或治疗转诊方面记录出色，但南卡罗来纳州乳腺癌死亡率方面的种族差异仍然存在。这些发现凸显了未来对种族差异的病因及其对乳腺癌生存影响进行研究的必要性。
