Parikh Divya A, Chudasama Rani, Agarwal Ankit, Rand Alexandar, Qureshi Muhammad M, Ngo Taylor, Hirsch Ariel E
Department of Radiation Oncology, Boston University School of Medicine, Boston, MA 02118, USA.
Int J Breast Cancer. 2015;2015:835074. doi: 10.1155/2015/835074. Epub 2015 Oct 28.
Objective. To examine the impact of patient demographics on mortality in breast cancer patients receiving care at a safety net academic medical center. Patients and Methods. 1128 patients were diagnosed with breast cancer at our institution between August 2004 and October 2011. Patient demographics were determined as follows: race/ethnicity, primary language, insurance type, age at diagnosis, marital status, income (determined by zip code), and AJCC tumor stage. Multivariate logistic regression analysis was performed to identify factors related to mortality at the end of follow-up in March 2012. Results. There was no significant difference in mortality by race/ethnicity, primary language, insurance type, or income in the multivariate adjusted model. An increased mortality was observed in patients who were single (OR = 2.36, CI = 1.28-4.37, p = 0.006), age > 70 years (OR = 3.88, CI = 1.13-11.48, p = 0.014), and AJCC stage IV (OR = 171.81, CI = 59.99-492.06, p < 0.0001). Conclusions. In this retrospective study, breast cancer patients who were single, presented at a later stage, or were older had increased incidence of mortality. Unlike other large-scale studies, non-White race, non-English primary language, low income, or Medicaid insurance did not result in worse outcomes.
目的。探讨患者人口统计学特征对在一家安全网学术医疗中心接受治疗的乳腺癌患者死亡率的影响。患者与方法。2004年8月至2011年10月期间,我院有1128例患者被诊断为乳腺癌。患者人口统计学特征确定如下:种族/民族、主要语言、保险类型、诊断时年龄、婚姻状况、收入(根据邮政编码确定)以及美国癌症联合委员会(AJCC)肿瘤分期。进行多因素逻辑回归分析,以确定与2012年3月随访结束时死亡率相关的因素。结果。在多因素校正模型中,种族/民族、主要语言、保险类型或收入对死亡率无显著差异。观察到单身患者(比值比[OR]=2.36,可信区间[CI]=1.28 - 4.37,p = 0.006)、年龄>70岁患者(OR = 3.88,CI = 1.13 - 11.48,p = 0.014)以及AJCC IV期患者(OR = 171.81,CI = 59.99 - 492.06,p < 0.0001)的死亡率增加。结论。在这项回顾性研究中,单身、就诊时处于晚期或年龄较大的乳腺癌患者死亡率增加。与其他大规模研究不同,非白人种族、非英语主要语言、低收入或医疗补助保险并未导致更差的结局。