Cheung Min Rex
FROS Radiation Oncology CyberKnife Center, 40-20 Main St., 4 Fl, Flushing NY, USA E-mail :
Asian Pac J Cancer Prev. 2013;14(12):7133-6. doi: 10.7314/apjcp.2013.14.12.7133.
We studied Surveillance, Epidemiology and End Results (SEER) breast cancer data of Georgia USA to analyze the impact of socio-economic factors on the disparity of breast cancer treatment outcome.
This study explored socio-economic, staging and treatment factors that were available in the SEER database for breast cancer from Georgia registry diagnosed in 2004-2009. An area under the receiver operating characteristic curve (ROC) was computed for each predictor to measure its discriminatory power. The best biological predictors were selected to be analyzed with socio-economic factors. Survival analysis, Kolmogorov- Smirnov 2-sample tests and Cox proportional hazard modeling were used for univariate and multivariate analyses of time to breast cancer specific survival data.
There were 34,671 patients included in this study, 99.3% being females with breast cancer. This study identified race and education attainment of county of residence as predictors of poor outcome. On multivariate analysis, these socio-economic factors remained independently prognostic. Overall, race and education status of the place of residence predicted up to 10% decrease in cause specific survival at 5 years.
Socio-economic factors are important determinants of breast cancer outcome and ensuring access to breast cancer treatment may eliminate disparities.
我们研究了美国佐治亚州的监测、流行病学和最终结果（SEER）乳腺癌数据，以分析社会经济因素对乳腺癌治疗结果差异的影响。
本研究探讨了2004 - 2009年佐治亚州登记处诊断的SEER数据库中可获得的社会经济、分期和治疗因素。计算每个预测因子的受试者工作特征曲线（ROC）下面积，以测量其判别能力。选择最佳生物学预测因子与社会经济因素进行分析。生存分析、柯尔莫哥洛夫 - 斯米尔诺夫双样本检验和Cox比例风险模型用于乳腺癌特异性生存数据时间的单变量和多变量分析。
本研究纳入34,671例患者，其中99.3%为女性乳腺癌患者。本研究确定居住地所在县的种族和教育程度是预后不良的预测因子。多变量分析显示，这些社会经济因素仍然具有独立的预后价值。总体而言，居住地的种族和教育状况预测5年特定病因生存率下降高达10%。
社会经济因素是乳腺癌治疗结果的重要决定因素，确保获得乳腺癌治疗可能消除差异。
