Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1441 Eastlake Avenue, Rm 4443, Los Angeles, CA, 90089, USA,
Cancer Causes Control. 2013 Oct;24(10):1821-36. doi: 10.1007/s10552-013-0260-7. Epub 2013 Jul 18.
Racial/ethnic disparities in mortality among US breast cancer patients are well documented. Our knowledge of the contribution of lifestyle factors to disease prognosis is based primarily on non-Latina Whites and is limited for Latina, African American, and Asian American women. To address this knowledge gap, the California Breast Cancer Survivorship Consortium (CBCSC) harmonized and pooled interview information (e.g., demographics, family history of breast cancer, parity, smoking, alcohol consumption) from six California-based breast cancer studies and assembled corresponding cancer registry data (clinical characteristics, mortality), resulting in 12,210 patients (6,501 non-Latina Whites, 2,060 African Americans, 2,032 Latinas, 1,505 Asian Americans, 112 other race/ethnicity) diagnosed with primary invasive breast cancer between 1993 and 2007. In total, 3,047 deaths (1,570 breast cancer specific) were observed with a mean (SD) follow-up of 8.3 (3.5) years. Cox proportional hazards regression models were fit to data to estimate hazards ratios (HRs) and 95 % confidence intervals (CIs) for overall and breast cancer-specific mortality. Compared with non-Latina Whites, the HR of breast cancer-specific mortality was 1.13 (95 % CI 0.97-1.33) for African Americans, 0.84 (95 % CI 0.70-1.00) for Latinas, and 0.60 (95 % CI 0.37-0.97) for Asian Americans after adjustment for age, tumor characteristics, and select lifestyle factors. The CBCSC represents a large and racially/ethnically diverse cohort of breast cancer patients from California. This cohort will enable analyses to jointly consider a variety of clinical, lifestyle, and contextual factors in attempting to explain the long-standing disparities in breast cancer outcomes.
美国乳腺癌患者的死亡率存在明显的种族/民族差异,这一点已得到充分证实。我们对于生活方式因素对疾病预后的影响的认识主要基于非拉丁裔白人,而对于拉丁裔、非裔美国人和亚裔美国人妇女的了解则有限。为了解决这一知识差距,加利福尼亚乳腺癌生存者联盟(CBCSC)对六个加利福尼亚州的乳腺癌研究中的访谈信息(例如人口统计学资料、乳腺癌家族史、生育史、吸烟、饮酒)进行了协调和汇总,并将相应的癌症登记数据(临床特征、死亡率)组合在一起,最终纳入了 12210 名(6501 名非拉丁裔白人、2060 名非裔美国人、2032 名拉丁裔、1505 名亚裔美国人、112 名其他种族/民族)于 1993 年至 2007 年间被诊断为原发性浸润性乳腺癌的患者。共有 3047 例死亡(1570 例死于乳腺癌),平均(SD)随访 8.3(3.5)年。使用 Cox 比例风险回归模型对数据进行拟合,以估计总死亡率和乳腺癌特异性死亡率的风险比(HRs)和 95 %置信区间(CIs)。与非拉丁裔白人相比,非洲裔美国人的乳腺癌特异性死亡率的 HR 为 1.13(95 % CI 0.97-1.33),拉丁裔为 0.84(95 % CI 0.70-1.00),亚裔美国人为 0.60(95 % CI 0.37-0.97),在调整年龄、肿瘤特征和部分生活方式因素后。CBCSC 代表了来自加利福尼亚州的一个大型、种族/民族多样化的乳腺癌患者队列。该队列将能够联合分析各种临床、生活方式和背景因素,试图解释乳腺癌结局长期存在的差异。