Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California.
Division of Research, Kaiser Permanente Northern California, Oakland, California.
Cancer Epidemiol Biomarkers Prev. 2017 Sep;26(9):1466-1469. doi: 10.1158/1055-9965.EPI-17-0148.
The U.S. Hispanic/Latino population is heterogeneous both socioculturally and by the proportion of European, Indigenous American, and African ancestry of the regions from which individuals originate. A previous study reported that genetic ancestry was associated with breast cancer survival among Latinas, independent of sociodemographic and tumor characteristics, suggesting that a genetic factor associated with ancestry may affect breast cancer survival. We evaluated the association of genetic ancestry with breast cancer outcomes among 506 Latina women with invasive breast cancer in the Pathways Study, a cohort study within Kaiser Permanente, an integrated health care delivery system. Proportional hazards models were used to assess the effect of ancestry on breast cancer recurrence (53 events), breast cancer-specific mortality (31 events) and all-cause mortality (54 events), with a mean follow-up time of 6 years. Indigenous American ancestry was not associated with breast cancer recurrence [HR = 1.00 per 10% increase; 95% confidence interval (CI), 0.86-1.16], breast cancer mortality (HR = 0.95; 95% CI, 0.77-1.17), or all-cause mortality (HR = 0.93; 95% CI, 0.80-1.08). Adjustment for sociodemographic variables, tumor characteristics, and treatment did not alter the associations. Our results suggest that previously reported differences in breast cancer survival by genetic ancestry may be overcome by improving health care access and/or quality. Improving health care access and quality may reduce breast cancer disparities among U.S. Latinas. .
美国西班牙裔/拉丁裔人群在社会文化方面存在异质性，而且其欧洲、美洲原住民和非洲血统的比例也因个体原籍地区而异。先前的一项研究报告称，遗传血统与拉丁裔女性的乳腺癌生存有关，独立于社会人口统计学和肿瘤特征，这表明与遗传相关的遗传因素可能会影响乳腺癌的生存。我们在 Kaiser Permanente 的一个队列研究——Pathways 研究中，评估了 506 名拉丁裔浸润性乳腺癌女性的遗传血统与乳腺癌结局之间的关系。该研究是一个综合医疗保健系统。使用比例风险模型评估了血统对乳腺癌复发（53 例事件）、乳腺癌特异性死亡率（31 例事件）和全因死亡率（54 例事件）的影响，平均随访时间为 6 年。美洲原住民血统与乳腺癌复发[风险比（HR）=每增加 10%的 1.00；95%置信区间（CI），0.86-1.16]、乳腺癌死亡率（HR=0.95；95%CI，0.77-1.17）或全因死亡率（HR=0.93；95%CI，0.80-1.08）无关。调整社会人口统计学变量、肿瘤特征和治疗方法并未改变这些关联。我们的研究结果表明，先前报道的遗传血统与乳腺癌生存之间的差异可能会通过改善医疗保健的可及性和/或质量来克服。改善医疗保健的可及性和质量可能会减少美国拉丁裔女性中的乳腺癌差异。
