Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Department of Nephrology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
JAMA Netw Open. 2020 Apr 1;3(4):e202950. doi: 10.1001/jamanetworkopen.2020.2950.
Information about stage of cancer at diagnosis, use of therapy, and survival among patients from different racial/ethnic groups with 1 of the most common cancers is lacking.
To assess stage of cancer at diagnosis, use of therapy, overall survival (OS), and cancer-specific survival (CSS) in patients with cancer from different racial/ethnic groups.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study included 950 377 Asian, black, white, and Hispanic patients who were diagnosed with prostate, ovarian, breast, stomach, pancreatic, lung, liver, esophageal, or colorectal cancers from January 2004 to December 2010. Data were collected using the Surveillance, Epidemiology, and End Results (SEER) database, and patients were observed for more than 5 years. Data analysis was conducted in July 2018.
Multivariable logistic and Cox regression were used to evaluate the differences in stage of cancer at diagnosis, treatment, and survival among patients from different racial/ethnic groups.
A total of 950 377 patients (499 070 [52.5%] men) were included in the study, with 681 251 white patients (71.7%; mean [SD] age, 65 [12] years), 116 015 black patients (12.2%; mean [SD] age, 62 [12] years), 65 718 Asian patients (6.9%; mean [SD] age, 63 [13] years), and 87 393 Hispanic patients (9.2%; mean [SD] age, 61 [13] years). Compared with Asian patients, black patients were more likely to have metastatic disease at diagnosis (odds ratio [OR], 1.144; 95% CI, 1.109-1.180; P < .001). Black and Hispanic patients were less likely to receive definitive treatment than Asian patients (black: adjusted OR, 0.630; 95% CI, 0.609-0.653; P < .001; Hispanic: adjusted OR, 0.751; 95% CI, 0.724-0.780; P < .001). White, black, and Hispanic patients were more likely to have poorer CSS and OS than Asian patients (CSS, white: adjusted HR, 1.310; 95% CI, 1.283-1.338; P < .001; black: adjusted HR, 1.645; 95% CI, 1.605-1.685; P < .001; Hispanic: adjusted HR, 1.300; 95% CI, 1.266-1.334; P < .001; OS, white: adjusted HR, 1.333; 95% CI, 1.310-1.357; P < .001; black: adjusted HR, 1.754; 95% CI, 1.719-1.789; P < .001; Hispanic: adjusted HR, 1.279; 95% CI, 1.269-1.326; P < .001).
In this study of patients with 1 of 9 leading cancers, stage at diagnosis, treatment, and survival were different by race and ethnicity. These findings may help to optimize treatment and improve outcomes.
缺乏不同种族/族裔群体中最常见癌症之一的患者在诊断时的癌症分期、治疗方法和生存信息。
评估不同种族/族裔群体中患有癌症的患者在诊断时的癌症分期、治疗、总生存率（OS）和癌症特异性生存率（CSS）。
设计、地点和参与者：本队列研究纳入了 950377 名亚洲、黑种人、白种人和西班牙裔患者，他们在 2004 年 1 月至 2010 年 12 月期间被诊断为前列腺癌、卵巢癌、乳腺癌、胃癌、胰腺癌、肺癌、肝癌、食管癌或结直肠癌。数据来自监测、流行病学和最终结果（SEER）数据库，对患者进行了超过 5 年的观察。数据分析于 2018 年 7 月进行。
使用多变量逻辑和 Cox 回归来评估不同种族/族裔群体患者在诊断、治疗和生存方面的差异。
研究共纳入 950377 名患者（499070 名男性），其中 681251 名白种人（71.7%；平均[SD]年龄，65[12]岁），116015 名黑种人（12.2%；平均[SD]年龄，62[12]岁），65718 名亚洲人（6.9%；平均[SD]年龄，63[13]岁）和 87393 名西班牙裔（9.2%；平均[SD]年龄，61[13]岁）。与亚洲患者相比，黑种人患者更有可能在诊断时患有转移性疾病（比值比[OR]，1.144；95%置信区间[CI]，1.109-1.180；P<0.001）。黑人和西班牙裔患者接受确定性治疗的可能性低于亚洲患者（黑人：调整 OR，0.630；95%CI，0.609-0.653；P<0.001；西班牙裔：调整 OR，0.751；95%CI，0.724-0.780；P<0.001）。白种人、黑种人和西班牙裔患者的 CSS 和 OS 均较亚洲患者差（CSS，白种人：调整 HR，1.310；95%CI，1.283-1.338；P<0.001；黑人：调整 HR，1.645；95%CI，1.605-1.685；P<0.001；西班牙裔：调整 HR，1.300；95%CI，1.266-1.334；P<0.001；OS，白种人：调整 HR，1.333；95%CI，1.310-1.357；P<0.001；黑人：调整 HR，1.754；95%CI，1.719-1.789；P<0.001；西班牙裔：调整 HR，1.279；95%CI，1.269-1.326；P<0.001）。
在这项针对 9 种主要癌症之一患者的研究中，种族和族裔群体在诊断时的分期、治疗和生存方面存在差异。这些发现可能有助于优化治疗并改善结果。
Zotero 插件