Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Bergheimer Str. 20, D-69115 Heidelberg, Germany.
Breast. 2010 Apr;19(2):109-14. doi: 10.1016/j.breast.2009.12.004. Epub 2010 Jan 8.
Various international comparisons of breast cancer survival have shown discrepancies which may reflect the impact of ethnicity or health care. Using databases from SEER 13 and from the Manila and Rizal Cancer Registries, age adjusted five-year absolute and relative survival estimates were computed and compared between Filipino-American breast cancer patients, Philippine residents and Caucasians in the US. Determinants of survival differences were examined using Cox proportional hazards modelling. Age adjusted five-year relative survival was almost identical in Filipino-Americans (89.1%) and Caucasians (87.7%), but much lower in the Philippine residents (58.4%). Large tumor size, lymph node involvement, distant metastasis, and the large proportion of women not receiving surgery explained a substantial portion of the excess mortality in Philippine residents. The moderate excess risk of Caucasians compared to Filipino-Americans was explained by age differences. Access to, utilization and affordability of cancer care facilities are important for reducing breast cancer deaths in developing countries.
各种国际乳腺癌生存比较显示出差异，这些差异可能反映了种族或医疗保健的影响。使用 SEER 13 数据库和马尼拉和黎刹癌症登记处的数据，计算了年龄调整后的五年绝对和相对生存率，并比较了在美国的菲律宾裔美国乳腺癌患者、菲律宾居民和白种人之间的差异。使用 Cox 比例风险模型检查了生存差异的决定因素。年龄调整后的五年相对生存率在菲律宾裔美国人（89.1%）和白种人（87.7%）中几乎相同，但在菲律宾居民中（58.4%）要低得多。肿瘤较大、淋巴结受累、远处转移以及未接受手术的女性比例较大，这解释了菲律宾居民中死亡率过高的很大一部分原因。与菲律宾裔美国人相比，白种人存在中等程度的超额风险，这是由年龄差异造成的。获得、利用和负担得起癌症治疗设施对于减少发展中国家的乳腺癌死亡人数非常重要。
