Foy Kevin Chu, Fisher James L, Lustberg Maryam B, Gray Darrell M, DeGraffinreid Cecilia R, Paskett Electra D
1College of Nursing, The Ohio State University, Columbus, USA.
2Comprehensive Cancer Center, The Ohio State University, Columbus, USA.
NPJ Breast Cancer. 2018 Mar 20;4:7. doi: 10.1038/s41523-018-0059-5. eCollection 2018.
African American (AA) women have a 42% higher breast cancer death rate compared to white women despite recent advancements in management of the disease. We examined racial differences in clinical and tumor characteristics, treatment and survival in patients diagnosed with breast cancer between 2005 and 2014 at a single institution, the James Cancer Hospital, and who were included in the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute Cancer Registry in Columbus OH. Statistical analyses included likelihood ratio chi-square tests for differences in proportions, as well as univariate and multivariate Cox proportional hazards regressions to examine associations between race and overall and progression-free survival probabilities. AA women made up 10.2% (469 of 4593) the sample. Average time to onset of treatment after diagnosis was almost two times longer in AA women compared to white women (62.0 days vs 35.5 days, < 0.0001). AA women were more likely to report past or current tobacco use, experience delays in treatment, have triple negative and late stage breast cancer, and were less likely to receive surgery, especially mastectomy and reconstruction following mastectomy. After adjustment for confounding factors (age, grade, and surgery), overall survival probability was significantly associated with race (HR = 1.33; 95% CI 1.03-1.72). These findings highlight the need for efforts focused on screening and receipt of prompt treatment among AA women diagnosed with breast cancer.
尽管近年来乳腺癌治疗取得了进展，但非裔美国（AA）女性的乳腺癌死亡率仍比白人女性高42%。我们研究了2005年至2014年在单一机构詹姆斯癌症医院被诊断为乳腺癌的患者的临床和肿瘤特征、治疗及生存方面的种族差异，这些患者被纳入俄亥俄州哥伦布市的亚瑟·G·詹姆斯癌症医院和理查德·J·索洛维研究所癌症登记处。统计分析包括用于比例差异的似然比卡方检验，以及单变量和多变量Cox比例风险回归，以检验种族与总生存概率和无进展生存概率之间的关联。AA女性占样本的10.2%（4593人中的469人）。与白人女性相比，AA女性诊断后开始治疗的平均时间几乎长两倍（62.0天对35.5天，<0.0001）。AA女性更有可能报告过去或现在吸烟，经历治疗延迟，患有三阴性和晚期乳腺癌，且接受手术的可能性较小，尤其是乳房切除术及乳房切除术后的重建手术。在对混杂因素（年龄、分级和手术）进行调整后，总生存概率与种族显著相关（HR = 1.33；95% CI 1.03 - 1.72）。这些发现凸显了有必要针对被诊断为乳腺癌的AA女性开展集中于筛查和及时治疗的工作。
