SUNY Downstate Medical Center, 450 Clarkson Avenue, Box 43, Brooklyn, NY 11203-2098, USA.
Breast Cancer Res Treat. 2010 Jul;122(2):515-20. doi: 10.1007/s10549-009-0702-9. Epub 2010 Jan 6.
In order to shed light on genetic and environmental factors contributing to breast cancer health disparities, anonymous data from the cancer registry in Brooklyn, NY and two countries in the Caribbean, have been analyzed and compared. De-identified data were obtained on 3,710 women from three cancer registries in Brooklyn (New York), Guyana, and Trinidad, all having been diagnosed with breast cancer between 1995 and 2007, with follow-up through to early 2009. There was a significant difference in breast cancer survival according to race, place of birth, and place of residence. Women of African origin had a significantly worse survival than White women. Women born in the Caribbean had significantly worse survival in comparison to their counterpart born in the US, independently from their ethnic background (adjusted hazard ratio: 1.6; 95% CI: 1.2-2.1). A significant lower breast cancer survival was observed in African Caribbean women living in the Caribbean (HR: 1.8; 95% CI: 1.6-2.1) versus African-Caribbean women born in the Caribbean and living in the US (HR: 1.3; 95% CI 1.1-1.7), versus African-descent women born and living in the US. This study suggests that biological, behavioral, environmental, and clinical factors play a significant role in the observed difference in breast cancer outcome in women of Afro Caribbean descent.
为了阐明导致乳腺癌健康差异的遗传和环境因素，对来自纽约布鲁克林癌症登记处和加勒比两个国家的匿名数据进行了分析和比较。从布鲁克林（纽约）、圭亚那和特立尼达的三个癌症登记处获得了 3710 名女性的匿名数据，这些女性均于 1995 年至 2007 年间被诊断患有乳腺癌，并随访至 2009 年初。种族、出生地和居住地对乳腺癌的生存有显著影响。非洲裔女性的生存状况明显差于白人女性。与在美国出生的女性相比，出生在加勒比地区的女性的生存状况明显更差，而与她们的种族背景无关（调整后的危险比：1.6；95%可信区间：1.2-2.1）。与出生在加勒比地区并居住在美国的非洲裔加勒比女性相比（HR：1.8；95%CI：1.6-2.1），居住在加勒比地区的非洲裔加勒比女性（HR：1.3；95%CI 1.1-1.7）的乳腺癌生存率显著降低，与出生和居住在美国的非洲裔女性相比。本研究表明，生物、行为、环境和临床因素在观察到的非裔加勒比女性乳腺癌结局差异中起重要作用。
