Ginsburg O M, Fischer H D, Shah B R, Lipscombe L, Fu L, Anderson G M, Rochon P A
Women's College Research Institute, Women's College Hospital, Toronto, ON. ; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON. ; Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON.
Institute for Clinical Evaluative Sciences, Toronto, ON.
Curr Oncol. 2015 Apr;22(2):97-104. doi: 10.3747/co.22.2359.
Breast cancer stage at diagnosis is an important predictor of survival. Our goal was to compare breast cancer stage at diagnosis (by American Joint Committee on Cancer criteria) in Chinese and South Asian women with stage at diagnosis in the remaining general population in Ontario.
We used the Ontario population-based cancer registry to identify all women diagnosed with breast cancer during 2005-2010, and we applied a validated surname algorithm to identify South Asian and Chinese women. We used logistic regression to compare, for Chinese or South Asian women and for the remaining general population, the frequency of diagnoses at stage ii compared with stage i and stages ii-iv compared with stage i.
The registry search identified 1304 Chinese women, 705 South Asian women, and 39,287 women in the remaining general population. The Chinese and South Asian populations were younger than the remaining population (mean: 54, 57, and 61 years respectively). Adjusted for age, South Asian women were more often diagnosed with breast cancer at stage ii than at stage i [odds ratio (or): 1.28; 95% confidence interval (ci): 1.08 to 1.51] or at stages ii-iv than at stage i (or: 1.27; 95% ci: 1.08 to 1.48); Chinese women were less likely to be diagnosed at stage ii than at stage i (or: 0.82; 95% ci: 0.72 to 0.92) or at stages ii-iv than at stage i (or: 0.73; 95% ci: 0.65 to 0.82).
Breast cancers were diagnosed at a later stage in South Asian women and at an earlier stage in Chinese women than in the remaining population. A more detailed analysis of ethnocultural factors influencing breast screening uptake, retention, and care-seeking behavior might be needed to help inform and evaluate tailored health promotion activities.
乳腺癌诊断时的分期是生存的重要预测指标。我们的目标是比较中国和南亚女性乳腺癌诊断时的分期（依据美国癌症联合委员会标准）与安大略省其余普通人群诊断时的分期。
我们利用安大略省基于人群的癌症登记处来识别2005年至2010年间所有被诊断为乳腺癌的女性，并应用经过验证的姓氏算法来识别南亚和中国女性。我们使用逻辑回归来比较中国或南亚女性以及其余普通人群中，ii期诊断频率与i期相比，以及ii - iv期诊断频率与i期相比的情况。
登记处搜索识别出1304名中国女性、705名南亚女性以及其余普通人群中的39287名女性。中国和南亚人群比其余人群更年轻（平均年龄分别为54岁、57岁和61岁）。经年龄调整后，南亚女性在ii期被诊断出乳腺癌的几率高于i期[比值比（OR）：1.28；95%置信区间（CI）：1.08至1.51]，在ii - iv期被诊断出乳腺癌的几率也高于i期（OR：1.27；95%CI：1.08至1.48）；中国女性在ii期被诊断出乳腺癌的可能性低于i期（OR：0.82；95%CI：0.72至0.92），在ii - iv期被诊断出乳腺癌的可能性也低于i期（OR：0.73；95%CI：0.65至0.82）。
与其余人群相比，南亚女性乳腺癌诊断时分期较晚，而中国女性诊断时分期较早。可能需要对影响乳房筛查参与、持续参与和寻求医疗行为的种族文化因素进行更详细的分析，以帮助为量身定制的健康促进活动提供信息并进行评估。
