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多数少数族裔社区中的乳腺癌治疗延迟:存在差异吗?

Breast cancer treatment delays in a majority minority community: is there a difference?

作者信息

Parsons Helen M, Lathrop Kate I, Schmidt Susanne, Mazo-Canola Marcela, Trevino-Jones Jessica, Speck Heather, Karnad Anand B

机构信息

University of Texas Health Science Center at San Antonio; and Cancer Therapy and Research Center, San Antonio, TX

University of Texas Health Science Center at San Antonio; and Cancer Therapy and Research Center, San Antonio, TX.

出版信息

J Oncol Pract. 2015 Mar;11(2):e144-53. doi: 10.1200/JOP.2014.000141. Epub 2014 Dec 16.

Abstract

PURPOSE

Recent studies from large nationwide cancer databases have consistently shown that Hispanic women with breast cancer have delays in treatment initiation compared with non-Hispanic white women. However, time to treatment initiation has not been studied in a community where Hispanics are the majority.

PATIENTS AND METHODS

We conducted a retrospective, observational study of 362 female patients with breast cancer treated at a large National Cancer Institute (NCI) -designated cancer center with a largely Hispanic population. We examined the relationship between race/ethnicity and time from mammogram to biopsy as well as time from biopsy to treatment initiation using Kaplan-Meier analyses and multivariable Cox proportional hazards regression.

RESULTS

Half of the female patients with breast cancer were of Hispanic descent (50.0%; n = 181). Hispanic patients were more likely to be obese, have an Eastern Cooperative Oncology Group functional status ≥ 1, and have higher histologic grade disease (all P ≤ .05); no differences in American Joint Committee on Cancer stage at diagnosis were observed. After comprehensive adjustment for demographic and clinical characteristics, we found no significant differences between Hispanic versus non-Hispanic white patients in time from mammogram to biopsy (hazard ratio [HR], 0.91; 95% CI, 0.68 to 1.21) or time from biopsy to treatment (HR, 1.13; 95% CI, 0.69 to 1.88).

CONCLUSION

Hispanic women and Non-Hispanic white women with breast cancer treated at an NCI-designated cancer center had similar times to biopsy and treatment initiation. These findings suggest that in majority minority communities with large cancer centers, racial disparities can be reduced. With a growing Hispanic population throughout the United States, future studies should examine the long-term impact on improved breast cancer survival in this population.

摘要

目的

来自全国大型癌症数据库的近期研究一致表明,与非西班牙裔白人女性相比,患乳腺癌的西班牙裔女性在开始治疗方面存在延迟。然而,在西班牙裔占多数的社区中,尚未对开始治疗的时间进行研究。

患者与方法

我们对在一家主要为西班牙裔人口的大型国立癌症研究所(NCI)指定癌症中心接受治疗的362名女性乳腺癌患者进行了一项回顾性观察研究。我们使用Kaplan-Meier分析和多变量Cox比例风险回归,研究了种族/民族与从乳房X光检查到活检的时间以及从活检到开始治疗的时间之间的关系。

结果

一半的女性乳腺癌患者为西班牙裔血统(50.0%;n = 181)。西班牙裔患者更有可能肥胖,东部肿瘤协作组功能状态≥1,且组织学分级疾病更高(所有P≤0.05);在诊断时的美国癌症联合委员会分期方面未观察到差异。在对人口统计学和临床特征进行全面调整后,我们发现西班牙裔与非西班牙裔白人患者在从乳房X光检查到活检的时间(风险比[HR],0.91;95%可信区间[CI],0.68至1.21)或从活检到治疗的时间(HR,1.13;95%CI,0.69至1.88)方面没有显著差异。

结论

在NCI指定癌症中心接受治疗的患乳腺癌的西班牙裔女性和非西班牙裔白人女性在活检和开始治疗的时间方面相似。这些发现表明,在拥有大型癌症中心的多数少数族裔社区中,种族差异可以减少。随着美国西班牙裔人口的不断增加,未来的研究应探讨这对该人群乳腺癌生存率提高的长期影响。

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