Department of Internal Medicine, Cancer Outcomes, Public Policy, and Effectiveness Research Center, Yale University School of Medicine, New Haven, CT, USA.
New England Sickle Cell Institute, Division of Hematology/Oncology, Neag Comprehensive Cancer Center, UConn Health, Farmington, CT, USA.
Br J Cancer. 2019 Apr;120(8):861-863. doi: 10.1038/s41416-019-0416-7. Epub 2019 Mar 20.
African-American (AA) cancer patients have long-experienced worse outcomes compared to non-Hispanic whites (NHW). No studies to date have evaluated the prognostic impact of sickle cell trait (SCT) and other inherited haemoglobinopathies, of which several are disproportionately high in the AA population. In a cohort analysis of treated patients diagnosed with breast or prostate cancer in the linked SEER-Medicare database, the relative risk (RR) for ≥1 serious adverse events (AEs), defined as hospitalisations or emergency department visits, was estimated for 371 AA patients with a haemoglobinopathy (AA+) compared to patients without haemoglobinopathies (17,303 AA-; 144,863 NHW-). AA+ patients had significantly increased risk for ≥1 AEs compared to AA- (RR = 1.19; 95% CI 1.11-1.27) and NHW- (RR = 1.23; 95% CI 1.15-1.31) patients. The magnitude of effect was similar by cancer type, and in analyses of AA+ with SCT only. Our findings suggest a novel hypothesis for disparities in cancer outcomes.
非裔美国（AA）癌症患者的预后一直比非西班牙裔白人（NHW）差。迄今为止，尚无研究评估镰状细胞特征（SCT）和其他遗传性血红蛋白病的预后影响，而其中几种在 AA 人群中比例过高。在 SEER-Medicare 数据库中接受治疗的患有乳腺癌或前列腺癌的患者的队列分析中，根据血红蛋白病（AA+）患者与无血红蛋白病（17303 名 AA-；144863 名 NHW-）患者定义≥1 次严重不良事件（AE）（定义为住院或急诊就诊）的相对风险（RR）。与 AA-（RR=1.19；95%CI1.11-1.27）和 NHW-（RR=1.23；95%CI1.15-1.31）患者相比，AA+患者发生≥1 次 AE 的风险显著增加。按癌症类型和仅分析 AA+与 SCT 进行分析，其效应幅度相似。我们的发现为癌症结局差异提出了一个新的假说。
