Du Xianglin L, Liu Chih-Chin
Division of Epidemiology, School of Public Health, University of Texas Health Science Center, Houston, TX 77030, USA.
J Health Care Poor Underserved. 2010 Aug;21(3):913-30. doi: 10.1353/hpu.0.0331.
To determine whether racial disparities persist in Medicare-insured elderly patients with head and neck cancer, we studied 7,480 patients diagnosed with head and neck cancer at age 65 or older in 1991-2002, identified from tumor registries maintained by the 16 areas participating in the Surveillance, Epidemiology and End Results program. Patients receiving cancer-directed surgery had significantly lower risks of both all-cause and disease-specific mortality than others; those with lower socioeconomic status were more likely to die of all causes than patients with higher socioeconomic status. African Americans had a marginally higher risk of all-cause mortality (hazard ratio = 1.19, 95% CI: 1.07-1.33), but had no significantly different risk of disease-specific mortality compared with Whites (1.09, 0.91-1.30). In conclusion, the risk of mortality was not significantly different among African Americans and Hispanics compared with Whites in specific tumor sites of head and neck cancer except a marginally elevated risk of all-cause mortality in African Americans with oral cavity tumor.
为了确定医疗保险覆盖的老年头颈癌患者中种族差异是否持续存在，我们研究了1991年至2002年间年龄在65岁及以上、被诊断为头颈癌的7480名患者，这些患者来自参与监测、流行病学和最终结果计划的16个地区所维护的肿瘤登记处。接受癌症定向手术的患者全因死亡率和疾病特异性死亡率均显著低于其他患者；社会经济地位较低的患者比社会经济地位较高的患者更有可能死于各种原因。非裔美国人全因死亡率的风险略高（风险比=1.19，95%置信区间：1.07-1.33），但与白人相比，疾病特异性死亡率的风险没有显著差异（1.09，0.91-1.30）。总之，在头颈癌的特定肿瘤部位，非裔美国人和西班牙裔与白人相比，死亡率风险没有显著差异，但口腔肿瘤的非裔美国人全因死亡率风险略有升高。
