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美国乳腺癌生存率的差异(2001 - 2009年):CONCORD - 2研究的结果

Disparities in breast cancer survival in the United States (2001-2009): Findings from the CONCORD-2 study.

作者信息

Miller Jacqueline W, Smith Judith Lee, Ryerson A Blythe, Tucker Thomas C, Allemani Claudia

机构信息

Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.

Kentucky Cancer Registry, University of Kentucky, Lexington, Kentucky.

出版信息

Cancer. 2017 Dec 15;123 Suppl 24(Suppl 24):5100-5118. doi: 10.1002/cncr.30988.

Abstract

BACKGROUND

Reducing breast cancer incidence and achieving equity in breast cancer outcomes remains a priority for public health practitioners, health care providers, policy makers, and health advocates. Monitoring breast cancer survival can help evaluate the effectiveness of health services, quantify inequities in outcomes between states or population subgroups, and inform efforts to improve the effectiveness of cancer management and treatment.

METHODS

We analyzed breast cancer survival using individual patient records from 37 statewide registries that participated in the CONCORD-2 study, covering approximately 80% of the US population. Females were diagnosed between 2001 and 2009 and were followed through December 31, 2009. Age-standardized net survival at 1 year, 3 years, and 5 years after diagnosis was estimated by state, race (white, black), stage at diagnosis, and calendar period (2001-2003 and 2004-2009).

RESULTS

Overall, 5-year breast cancer net survival was very high (88.2%). Survival remained remarkably high from 2001 through 2009. Between 2001 and 2003, survival was 89.1% for white females and 76.9% for black females. Between 2004 and 2009, survival was 89.6% for white females and 78.4% for black females.

CONCLUSIONS

Breast cancer survival was more than 10 percentage points lower for black females than for white females, and this difference persisted over time. Reducing racial disparities in survival remains a challenge that requires broad, coordinated efforts at the federal, state, and local levels. Monitoring trends in breast cancer survival can highlight populations in need of improved cancer management and treatment. Cancer 2017;123:5100-18. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

摘要

背景

降低乳腺癌发病率并实现乳腺癌治疗结果的公平性仍是公共卫生从业者、医疗服务提供者、政策制定者及健康倡导者的首要任务。监测乳腺癌生存率有助于评估卫生服务的有效性,量化各州或人群亚组之间治疗结果的不公平性,并为提高癌症管理和治疗效果的努力提供信息。

方法

我们使用了参与CONCORD - 2研究的37个州登记处的个体患者记录来分析乳腺癌生存率,这些登记处覆盖了约80%的美国人口。女性患者于2001年至2009年期间被诊断,并随访至2009年12月31日。按州、种族(白人、黑人)、诊断时的分期以及日历时间段(2001 - 2003年和2004 - 2009年)估计诊断后1年、3年和5年的年龄标准化净生存率。

结果

总体而言,乳腺癌5年净生存率非常高(88.2%)。2001年至2009年期间生存率一直保持在很高水平。2001年至2003年,白人女性生存率为89.1%,黑人女性为76.9%。2004年至2009年,白人女性生存率为89.6%,黑人女性为78.4%。

结论

黑人女性乳腺癌生存率比白人女性低10多个百分点,且这种差异长期存在。减少生存率方面的种族差异仍是一项挑战,需要联邦、州和地方各级广泛、协调的努力。监测乳腺癌生存率趋势可以凸显需要改善癌症管理和治疗的人群。《癌症》2017年;123:5100 - 18。2017年发表。本文为美国政府作品,在美国属于公共领域。

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