BC Cancer Agency, Vancouver, BC, Canada.
BMC Cancer. 2010 Apr 21;10:154. doi: 10.1186/1471-2407-10-154.
Racial and ethnic disparities in breast cancer incidence, stage at diagnosis, survival and mortality are well documented; but few studies have reported on disparities in breast cancer treatment. This paper compares the treatment received by breast cancer patients in British Columbia (BC) for three ethnic groups and three time periods. Values for breast cancer treatments received in the BC general population are provided for reference.
Information on patients, tumour characteristics and treatment was obtained from BC Cancer Registry (BCCR) and BC Cancer Agency (BCCA) records. Treatment among ethnic groups was analyzed by stage at diagnosis and time period at diagnosis. Differences among the three ethnic groups were tested using chi-square tests, Fisher exact tests and a multivariate logistic model.
There was no significant difference in overall surgery use for stage I and II disease between the ethnic groups, however there were significant differences when surgery with and without radiation were considered separately. These differences did not change significantly with time. Treatment with chemotherapy and hormone therapy did not differ among the minority groups.
The description of treatment differences is the first step to guiding interventions that reduce ethnic disparities. Specific studies need to examine reasons for the observed differences and the influence of culture and beliefs.
乳腺癌的发病率、诊断时的分期、生存和死亡率的种族和民族差异已有大量文献记载；但很少有研究报告乳腺癌治疗方面的差异。本文比较了不列颠哥伦比亚省（BC）三种族裔和三个时期的乳腺癌患者所接受的治疗。提供了 BC 一般人群接受的乳腺癌治疗值作为参考。
从不列颠哥伦比亚癌症登记处（BCCR）和不列颠哥伦比亚癌症机构（BCCA）的记录中获取有关患者、肿瘤特征和治疗的信息。按诊断时的分期和诊断时的时间段分析不同种族群体之间的治疗情况。使用卡方检验、Fisher 确切检验和多变量逻辑模型检验三组之间的差异。
在 I 期和 II 期疾病中，各种族之间的整体手术使用率没有显著差异，但在考虑是否联合放疗时存在显著差异。这些差异随着时间的推移没有明显变化。少数族裔群体之间的化疗和激素治疗没有差异。
描述治疗差异是指导减少种族差异干预措施的第一步。需要进行具体研究来检验观察到的差异的原因以及文化和信仰的影响。
