在乳腺摄影时代，乳腺癌诊断时的种族差异。
Racial differences in breast cancer stage at diagnosis in the mammography era.
机构信息
Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
出版信息
Am J Public Health. 2013 Jan;103(1):170-6. doi: 10.2105/AJPH.2011.300550. Epub 2012 Jun 14.
OBJECTIVES
We assessed racial differences in breast cancer mortality by stage at diagnosis, since mammography became available.
METHODS
We calculated adjusted odds of distant (versus local or regional) tumors for 143,249 White and 13,571 Black women aged 50 to 69 years, diagnosed with breast cancer between 1982 and 2007 and living in a Surveillance, Epidemiology, and End Results region. We compared linear trends in stage at diagnosis before and after 1998.
RESULTS
Distant-stage cancer was diagnosed in 5.8% of White and 10.2% of Black participants. The Black-White disparity in distant tumors narrowed until 1998 (1998 adjusted difference = 0.65%), before increasing. Between 1982 and 1997, the proportion of distant tumors decreased for Blacks (adjusted odds ratio [AOR]/y = 0.973; 95% confidence interval [CI] = 0.960, 0.987) and Whites (AOR/y = 0.978; 95% CI = 0.973, 0.983), with no racial differences (P = .47). From 1998 to 2007, the odds of distant versus local or regional tumors increased for Blacks (AOR/y = 1.036; 95% CI = 1.013, 1.060) and Whites (AOR/y = 1.011; 95% CI = 1.002, 1.021); the rate of increase was greater for Blacks than Whites (P = .04).
CONCLUSIONS
In the mammography era, racial disparities remain in stage at diagnosis.
目的
我们评估了自乳房 X 光检查普及以来，不同种族在诊断时的乳腺癌死亡率的差异。
方法
我们计算了 143249 名年龄在 50 至 69 岁之间的白人女性和 13571 名黑人女性的远处（与局部或区域）肿瘤的调整比值比，这些女性在 1982 年至 2007 年间被诊断患有乳腺癌且居住在监测、流行病学和最终结果地区。我们比较了 1998 年前和后诊断时的阶段线性趋势。
结果
5.8%的白人患者和 10.2%的黑人患者被诊断为远处癌症。直到 1998 年（1998 年调整差异=0.65%），黑人和白人之间的远处肿瘤差异才缩小，然后才增加。在 1982 年至 1997 年期间，黑人远处肿瘤的比例下降（调整比值比[AOR]/年=0.973；95%置信区间[CI]=0.960，0.987），白人的比例也下降（AOR/年=0.978；95%CI=0.973，0.983），但无种族差异（P=0.47）。从 1998 年到 2007 年，黑人远处肿瘤的几率相对于局部或区域肿瘤增加（AOR/年=1.036；95%CI=1.013，1.060），白人也增加（AOR/年=1.011；95%CI=1.002，1.021）；黑人的增长率高于白人（P=0.04）。
结论
在乳房 X 光检查时代，诊断时的种族差异仍然存在。
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