Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington.
Division of Gynecologic Oncology, University of Washington, Seattle, Washington.
Cancer Med. 2017 Sep;6(9):2153-2163. doi: 10.1002/cam4.1141. Epub 2017 Aug 4.
To assess differences in the receipt of preventive health services by race/ethnicity among older women with endometrial cancer enrolled in Medicare, we conducted a retrospective population-based cohort study of women diagnosed with endometrial cancer from 2001 to 2011 in the Surveillance Epidemiology and End Results (SEER)-Medicare database. Women with stage I or II endometrial cancer of epithelial origin were included. The exposure was race/ethnicity (Non-Hispanic [NH] White, NH Black, Hispanic, and NH Asian/Pacific Islander [PI]). The services examined were receipt of influenza vaccination and screening tests for diabetes mellitus, hyperlipidemia, and breast cancer. We used multivariate logistic regression to estimate odds ratios with 95% confidence intervals (CI) adjusted for age, region, and year of diagnosis. A total of 13,054 women were included. In the 2 years after diagnosis, receipt of any influenza vaccine ranged from 45% among NH Black women to 67% among NH White women; receipt of a mammogram ranged from 65% among NH Black women to 74% among NH White women. Relative to NH White women, NH Black women had a lower likelihood of receiving both influenza vaccination (adjusted odds ratio [aOR] 0.40, 95% CI 0.33-0.44) and screening mammography (aOR 0.64, 95% CI 0.52-0.79). Hispanic women also were less likely to receive influenza vaccination than NH White women (aOR 0.61, 95% CI 0.51-0.72). There were no significant differences across racial groups for diabetes or cholesterol screening services. Among older women with early-stage endometrial cancer, racial disparities exist in the utilization of some preventive services.
为了评估在接受 Medicare 治疗的老年子宫内膜癌女性中，不同种族/族裔群体接受预防保健服务的差异，我们对 2001 年至 2011 年间 Surveillance Epidemiology and End Results（SEER）-Medicare 数据库中诊断为子宫内膜癌的女性进行了回顾性基于人群的队列研究。纳入的女性为上皮起源的 I 期或 II 期子宫内膜癌患者。暴露因素为种族/族裔（非西班牙裔[NH]白人、NH 黑人、西班牙裔和 NH 亚洲/太平洋岛民[PI]）。检查的服务包括流感疫苗接种和糖尿病、高血脂和乳腺癌筛查检测的接受情况。我们使用多变量逻辑回归来估计调整年龄、地区和诊断年份后的优势比（OR）及其 95%置信区间（CI）。共纳入 13054 名女性。在诊断后的 2 年内，NH 黑人女性接种任何流感疫苗的比例为 45%，NH 白人女性为 67%；NH 黑人女性接受乳房 X 光检查的比例为 65%，NH 白人女性为 74%。与 NH 白人女性相比，NH 黑人女性接种流感疫苗的可能性较低（调整 OR [aOR] 0.40，95%CI 0.33-0.44），筛查乳房 X 光检查的可能性也较低（aOR 0.64，95%CI 0.52-0.79）。与 NH 白人女性相比，西班牙裔女性接种流感疫苗的可能性也较低（aOR 0.61，95%CI 0.51-0.72）。不同种族群体在糖尿病或胆固醇筛查服务方面没有显著差异。在患有早期子宫内膜癌的老年女性中，在某些预防保健服务的利用方面存在种族差异。
