University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania.
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio.
Cancer Epidemiol Biomarkers Prev. 2023 Feb 6;32(2):157-158. doi: 10.1158/1055-9965.EPI-22-1111.
Disparities in treatment intensity can contribute to racial disparities in overall breast cancer survival. A natural extension of measuring racial disparities in treatment intensity is consideration of the distribution of treatment toxicities, symptoms, and distress that lead to chemotherapy dose reductions, holds or early termination. There is growing evidence that therapeutic toxicity during early-stage breast cancer treatment may be greater among Black women than White. Important components of symptom management involve the communication of symptoms, the self-care abilities of the patient, the patient's perception of the clinical encounter, and the patient centeredness of the clinical encounter. Racial differences in the symptom reporting, the clinical "reception" and response to symptoms, the prescribed management, and the patient adherence to symptom management requires further investigation. Further research must also consider the structural inequities, as well as institutional and interpersonal racism that contribute to racial differences in cancer symptom burden leading to potential decreases in dose intensity of potentially life-saving early cancer treatment. See related article by Hu et al., p. 167.
治疗强度的差异可能导致整体乳腺癌生存的种族差异。衡量治疗强度的种族差异的自然延伸是考虑导致化疗剂量减少、暂停或提前终止的治疗毒性、症状和痛苦的分布。越来越多的证据表明，黑人女性在接受早期乳腺癌治疗时的治疗毒性可能比白人女性更大。症状管理的重要组成部分包括症状的沟通、患者的自我护理能力、患者对临床接触的感知以及临床接触的以患者为中心。症状报告、临床“接待”和对症状的反应、规定的管理以及患者对症状管理的依从性方面的种族差异需要进一步调查。进一步的研究还必须考虑结构不平等以及机构和人际种族主义，这些因素导致癌症症状负担的种族差异，从而可能降低潜在的救命早期癌症治疗的剂量强度。详见 Hu 等人的相关文章，第 167 页。
