J Health Care Poor Underserved. 2020;31(3):1308-1322. doi: 10.1353/hpu.2020.0096.
We used data from the Surveillance, Epidemiology, and End Results Program to examine trends in breast cancer treatment and survival among a large sample of American Indian and Alaska Native women diagnosed from 2000-2015. Kaplan-Meier and Cox proportional hazard models were used to estimate survival. Alaska Natives were more likely to undergo mastectomy (48% compared with 39% of American Indians and 36% of non-Hispanic Whites) and were less likely to receive breast reconstruction following mastectomy (9% compared with 17% of American Indians and 28% of non-Hispanic Whites). Alaska Natives had both lower overall (HR: 1.40 95% CI: 1.19-1.65) and breast-cancer specific (HR: 1.29, 95% CI: 1.03, 1.63) survival compared with non-Hispanic Whites. Survival differences across the three racial groups varied significantly by age. Efforts to improve survival among American Indian and Alaska Native populations will need to address barriers to access among these vulnerable populations.
我们利用监测、流行病学和最终结果计划的数据，对 2000 年至 2015 年间被诊断为乳腺癌的大量美国印第安人和阿拉斯加原住民女性的治疗和生存趋势进行了研究。Kaplan-Meier 和 Cox 比例风险模型用于估计生存情况。与美国印第安人（39%）和非西班牙裔白人（36%）相比，阿拉斯加原住民更有可能接受乳房切除术（48%），并且在接受乳房切除术后接受乳房重建的可能性较小（9%）与美国印第安人（17%）和非西班牙裔白人（28%）相比。与非西班牙裔白人相比，阿拉斯加原住民的整体（HR：1.40 95%CI：1.19-1.65）和乳腺癌特异性（HR：1.29，95%CI：1.03，1.63）生存率均较低。这三个种族群体的生存率差异在不同年龄段有显著差异。要提高美国印第安人和阿拉斯加原住民的生存率，就需要解决这些弱势群体获得治疗的障碍。
