Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, M4-C308, Seattle, WA 98109-1024, USA.
Breast Cancer Res Treat. 2011 Jun;127(3):729-38. doi: 10.1007/s10549-010-1191-6. Epub 2010 Oct 7.
Disparities in breast cancer stage and mortality by race/ethnicity in the United States are persistent and well known. However, few studies have assessed differences across racial/ethnic subgroups of women broadly defined as Hispanic, Asian, or Pacific Islander, particularly using more recent data. Using data from 17 population-based cancer registries in the Surveillance, Epidemiology, and End Results (SEER) program, we evaluated the relationships between race/ethnicity and breast cancer stage, hormone receptor status, treatment, and mortality. The cohort consisted of 229,594 women 40-79 years of age diagnosed with invasive breast carcinoma between January 2000 and December 2006, including 176,094 non-Hispanic whites, 20,486 Blacks, 15,835 Hispanic whites, 14,951 Asians, 1,224 Pacific Islanders, and 1,004 American Indians/Alaska Natives. With respect to statistically significant findings, American Indian/Alaska Native, Asian Indian/Pakistani, Black, Filipino, Hawaiian, Mexican, Puerto Rican, and Samoan women had 1.3-7.1-fold higher odds of presenting with stage IV breast cancer compared to non-Hispanic white women. Almost all groups were more likely to be diagnosed with estrogen receptor-negative/progesterone receptor-negative (ER-/PR-) disease with Black and Puerto Rican women having the highest odds ratios (2.4 and 1.9-fold increases, respectively) compared to non-Hispanic whites. Lastly, Black, Hawaiian, Puerto Rican, and Samoan patients had 1.5-1.8-fold elevated risks of breast cancer-specific mortality. Breast cancer disparities persist by race/ethnicity, though there is substantial variation within subgroups of women broadly defined as Hispanic or Asian. Targeted, multi-pronged interventions that are culturally appropriate may be important means of reducing the magnitudes of these disparities.
美国的种族/族裔之间乳腺癌分期和死亡率的差异是持续存在且众所周知的。然而，很少有研究评估过广泛定义为西班牙裔、亚洲裔或太平洋岛裔的女性种族/族裔亚组之间的差异，特别是使用最近的数据。我们使用监测、流行病学和最终结果（SEER）计划中 17 个基于人群的癌症登记处的数据，评估了种族/族裔与乳腺癌分期、激素受体状态、治疗和死亡率之间的关系。该队列包括 229594 名 40-79 岁之间被诊断为浸润性乳腺癌的女性，她们的诊断时间为 2000 年 1 月至 2006 年 12 月，其中包括 176094 名非西班牙裔白人、20486 名黑人、15835 名西班牙裔白人、14951 名亚洲人、1224 名太平洋岛民和 1004 名美洲印第安人/阿拉斯加原住民。关于具有统计学意义的发现，与非西班牙裔白人相比，美洲印第安人/阿拉斯加原住民、亚裔印度人/巴基斯坦人、黑人、菲律宾人、夏威夷人、墨西哥人、波多黎各人、萨摩亚人患 IV 期乳腺癌的几率高 1.3-7.1 倍。几乎所有群体被诊断为雌激素受体阴性/孕激素受体阴性（ER-/PR-）疾病的可能性都更高，其中黑人妇女和波多黎各妇女的比值比最高（分别增加 2.4 倍和 1.9 倍），而非西班牙裔白人。最后，黑人、夏威夷人、波多黎各人和萨摩亚人患乳腺癌特异性死亡的风险增加了 1.5-1.8 倍。种族/族裔之间的乳腺癌差异仍然存在，但在广泛定义为西班牙裔或亚洲裔的女性亚组中存在很大差异。有针对性的、多管齐下的、文化上适当的干预措施可能是减少这些差异程度的重要手段。
