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西班牙裔白人女性与非西班牙裔白人女性在宫颈癌特征及生存方面的差异。

Disparities in Cervical Cancer Characteristics and Survival Between White Hispanics and White Non-Hispanic Women.

作者信息

Khan Hafiz M R, Gabbidon Kemesha, Saxena Anshul, Abdool-Ghany Faheema, Dodge John M, Lenzmeier Taylor

机构信息

1 Department of Public Health, Texas Tech University Health Sciences Center , Lubbock, Texas.

2 Department of Health Promotion and Disease Prevention, Florida International University , Miami, Florida.

出版信息

J Womens Health (Larchmt). 2016 Oct;25(10):1052-1058. doi: 10.1089/jwh.2015.5585. Epub 2016 Jun 10.

Abstract

BACKGROUND

Cervical cancer is the second most common cancer among women resulting in nearly 500,000 cases annually. Screening leads to better treatment and survival time. However, human papillomavirus (HPV) exposure, screening, and treatment vary among races and ethnicities in the United States. The purpose of this study is to examine disparities in characteristics of cervical cancer and survival of cases between White Hispanic (WH) and White non-Hispanic (WNH) women in the United States.

METHODS

We used a stratified random sampling method to select cervical cancer patient records from nine states; a simple random sampling method to extract the demographic and disease characteristics data within states from the Surveillance Epidemiology and End Results (SEER) database. We used statistical probability distribution methods for discrete and continuous data. The chi-square test and independent samples t-test were used to evaluate statistically significant differences. Furthermore, the Cox Proportional Regression and the Kaplan-Meier survival estimators were used to compare WH and WNH population survival times in the United States.

RESULTS

The samples of WNH and WH women included 4,000 cervical cancer cases from 1973-2009. There were statistically significant differences between ethnicities: marital status (p < 0.001); primary site of cancer (p < 0.001); lymph node involvement (p < 0.001); grading and differentiation (p < 0.0001); and tumor behavior (p < 0.001). The mean age of diagnosis for both groups showed no statistical differences. However, the mean survival time for WNH was 221.7 (standard deviation [SD] = 118.1) months and for WH was 190.3 (SD = 120.3), which differed significantly (p < 0.001).

CONCLUSIONS

Clear disparities exist in risk factors, cervical cancer characteristics, and survival time between WH and WNH women.

摘要

背景

宫颈癌是女性中第二常见的癌症,每年导致近50万例病例。筛查可带来更好的治疗效果和生存时间。然而,在美国,不同种族和族裔的人乳头瘤病毒(HPV)暴露、筛查和治疗情况存在差异。本研究的目的是调查美国西班牙裔白人(WH)和非西班牙裔白人(WNH)女性在宫颈癌特征和病例生存方面的差异。

方法

我们采用分层随机抽样方法从九个州选取宫颈癌患者记录;采用简单随机抽样方法从监测、流行病学和最终结果(SEER)数据库中提取各州内的人口统计学和疾病特征数据。我们对离散和连续数据使用统计概率分布方法。采用卡方检验和独立样本t检验来评估统计学上的显著差异。此外,使用Cox比例回归和Kaplan-Meier生存估计器来比较美国WH和WNH人群的生存时间。

结果

WNH和WH女性的样本包括1973 - 2009年的4000例宫颈癌病例。种族之间存在统计学上的显著差异:婚姻状况(p < 0.001);癌症原发部位(p < 0.001);淋巴结受累情况(p < 0.001);分级和分化(p < 0.0001);以及肿瘤行为(p < 0.001)。两组的平均诊断年龄无统计学差异。然而,WNH的平均生存时间为221.7(标准差[SD]=118.1)个月,WH为190.3(SD = 120.3),差异显著(p < 0.001)。

结论

WH和WNH女性在风险因素、宫颈癌特征和生存时间方面存在明显差异。

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