Klein Amanda, Villareal Michael, Radpour Sepeadeh, Goodgame Boone, Ali Sadia, Clark Adam, Uecker John
Am Surg. 2018 Nov 1;84(11):1787-1789.
Historically, the Hispanic population in the United States has had a lower incidence of cancer than the matched non-Hispanic population, despite disparities in access to health care, screening, and prevention. Our experience in Austin, Texas, directly contradicts this. We have seen a disproportionate amount of young Hispanic patients with advanced malignancies, particularly of the breast. The aim of this study was to compare the incidence of advanced breast malignancies. We performed a retrospective review over a 10-year period (2003-2013) of all newly diagnosed breast cancer patients. Data were collected from the cancer registry. Patients were divided into two groups: Hispanic non-Hispanic descent, with a subgroup of those aged less than 50 years. Primary outcome was the incidence of advanced cancers (stage 3 or 4). There were a total of 3968 breast cancer patients seen in our Shivers Cancer Center from 2003 to 2013, with an overall incidence of advanced breast cancer of 11.5 per cent. Of the patients aged less than 50 years, 14.2 per cent had advanced breast cancer. However, the rate among Hispanic patients was 21.3 per cent, whereas in non-Hispanic patients it was 13.5 per cent, = 0.002. Being Hispanic was found to be an independent predictor of having advanced malignancies at a young age (odds ratio 1.7, confidence interval 1.1-2.5, = 0.01). Here in Austin, Texas, we have found a higher overall incidence of breast cancer among young Hispanic women. This is important to recognize because more efforts may be required to increase screening and health-care access to this population.
从历史上看,美国的西班牙裔人口患癌率低于与之匹配的非西班牙裔人口,尽管在获得医疗保健、筛查和预防方面存在差异。我们在得克萨斯州奥斯汀的经验却直接与此相悖。我们看到大量年轻的西班牙裔患者患有晚期恶性肿瘤,尤其是乳腺癌。本研究的目的是比较晚期乳腺癌的发病率。我们对2003年至2013年这10年间所有新诊断的乳腺癌患者进行了回顾性研究。数据从癌症登记处收集。患者分为两组:西班牙裔和非西班牙裔血统,其中年龄小于50岁的患者单独作为一个亚组。主要结局指标是晚期癌症(3期或4期)的发病率。2003年至2013年期间,我们的希弗斯癌症中心共接待了3968例乳腺癌患者,晚期乳腺癌的总体发病率为11.5%。在年龄小于50岁的患者中,14.2%患有晚期乳腺癌。然而,西班牙裔患者的这一比例为21.3%,而非西班牙裔患者为13.5%,P = 0.002。研究发现,西班牙裔是年轻时患晚期恶性肿瘤的独立预测因素(优势比1.7,置信区间1.1 - 2.5,P = 0.01)。在得克萨斯州奥斯汀这里,我们发现年轻西班牙裔女性的乳腺癌总体发病率更高。认识到这一点很重要,因为可能需要付出更多努力来增加对这一人群的筛查和医疗保健服务。