Tapia Kriscia A, Garvey Gail, Mc Entee Mark, Rickard Mary, Brennan Patrick
Faculty of Health Sciences, The University of Sydney, New South Wales, Australia. Email:
Asian Pac J Cancer Prev. 2017 Apr 1;18(4):873-884. doi: 10.22034/APJCP.2017.18.4.873.
The Indigenous people of Australia face significant health gaps compared with the general population, with lower life expectancies, higher rates of death, and chronic illness occurring more often than in non-indigenous Australians. Cancer is the second largest contributor to the burden of disease with breast cancer being the most common invasive cancer diagnosed for females. Despite a lower breast cancer incidence compared with non-indigenous women, fatalities occur at an elevated rate and breast cancers have an earlier age of onset. For indigenous women there are also more advanced and distant tumours at diagnosis, fewer hospitalisations for breast cancer, and lower participation in breast screening. Concomitantly there are demographic, socio-economic and lifestyle factors associated with breast cancer risks that are heavily represented within Indigenous communities. The aim of this two-part narrative review is to examine the available evidence on breast cancer and its risk factors in Australian Indigenous women. Part One presents a summary of the latest incidence, survival and mortality data. Part Two presents the risk factors most strongly associated with breast cancer including age, place of residence, family risk, genetics, reproductive history, tobacco use, alcohol intake, physical activity, participation in screening and breast density. With increasing emphasis on personalized health care, a clear understanding of breast cancer incidence, survival, mortality, and causal agents within the Indigenous population is required if breast cancer prevention and management is to be optimized for Indigenous Australians.
与普通人群相比，澳大利亚原住民面临着巨大的健康差距，他们的预期寿命较低，死亡率较高，慢性病的发病率也高于非原住民澳大利亚人。癌症是疾病负担的第二大成因，其中乳腺癌是女性中最常见的浸润性癌症。尽管与非原住民女性相比，乳腺癌发病率较低，但原住民女性因乳腺癌死亡的比例更高，且发病年龄更早。对于原住民女性而言，确诊时肿瘤更晚期、转移更广泛，因乳腺癌住院的次数更少，参与乳房筛查的比例也更低。与此同时，与乳腺癌风险相关的人口、社会经济和生活方式因素在原住民社区中也极为普遍。这篇分为两部分的叙述性综述旨在研究澳大利亚原住民女性乳腺癌及其风险因素的现有证据。第一部分总结了最新的发病率、生存率和死亡率数据。第二部分介绍了与乳腺癌最密切相关的风险因素，包括年龄、居住地、家族风险、遗传因素、生殖史、烟草使用、酒精摄入、体育活动、参与筛查情况以及乳房密度。随着对个性化医疗的日益重视，如果要为澳大利亚原住民优化乳腺癌的预防和管理，就需要清楚了解原住民人群中乳腺癌的发病率、生存率、死亡率及病因。
