Adams Swann Arp, Fleming Alexandria, Brandt Heather M, Hurley Deborah, Bolick-Aldrich Susan, Bond Sharon M, Hebert James R
USC, 915 Green Street, Room 244, Columbia, SC 29208, USA.
J S C Med Assoc. 2009 Dec;105(7):237-44.
South Carolina (SC) has some of the largest health disparities in the nation, in particular cancer mortality rates that disfavor African Americans (AA) in comparison to European Americans (EA) with 37% higher incidence and 61% higher mortality rates for AA women compared to EA women. Consequently, the purpose of this investigation was to examine and compare the impact of race on survival among cervical cancer patients in SC. Data from the SC Central Cancer Registry on all AA and EA cervical cancer patients in SC were analyzed for this investigation. All women greater than 19 years of age with a histopathologically-confirmed cervical neoplasm were included. Kaplan Meier survival curves were calculated and compared for each racial group using the log rank test statistic. Significant differences between races were noted for alcohol use, grade, histology, marital status, and vital status. AA women with cervical cancer had significantly decreased survival compared to EA women (49% vs. 66%, p < 0.01). This same trend was noted for all grade, histology, and stage types. We found significantly decreased survival among AA women with cervical cancer compared to EA women, which persisted even among AA and EA women with the same disease stage, grade, or histology. The causes of these disparities are most likely multi-faceted and interdependent. These findings emphasize the need for intervention into the myriad of factors ranging from the biological and genetic to the environmental and structural barriers impacting cervical cancer mortality.
南卡罗来纳州(SC)存在着美国国内一些最为严重的健康差异问题,尤其是癌症死亡率方面,与欧裔美国人(EA)相比,非裔美国人(AA)处于劣势,非裔美国女性的发病率比欧裔美国女性高37%,死亡率高61%。因此,本调查的目的是研究并比较种族对南卡罗来纳州宫颈癌患者生存率的影响。本调查分析了南卡罗来纳州中央癌症登记处有关该州所有非裔和欧裔宫颈癌患者的数据。纳入所有年龄大于19岁且经组织病理学确诊为宫颈肿瘤的女性。使用对数秩检验统计量计算并比较每个种族组的Kaplan Meier生存曲线。在饮酒情况、分级、组织学类型、婚姻状况和生命状态方面,种族之间存在显著差异。与欧裔美国女性相比,非裔美国宫颈癌女性的生存率显著降低(49%对66%,p<0.01)。所有分级、组织学类型和分期类型均呈现相同趋势。我们发现,与欧裔美国女性相比,非裔美国宫颈癌女性的生存率显著降低,即使在疾病分期、分级或组织学类型相同的非裔和欧裔美国女性中,这种情况依然存在。这些差异的原因很可能是多方面且相互依存的。这些发现强调了有必要对从生物和遗传因素到影响宫颈癌死亡率的环境和结构障碍等众多因素进行干预。