Steinhorn S C, Myers M H, Hankey B F, Pelham V F
Am J Epidemiol. 1986 Jul;124(1):85-93. doi: 10.1093/oxfordjournals.aje.a114373.
Prognostic factors leading to the survival advantage of white women over black women with uterine corpus cancer were evaluated by using a series of patients diagnosed from 1973-1977 in three geographic areas of the United States participating in the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Higher survival rates were observed among women under age 55 years, with stage I disease, and living in higher socioeconomic census tracts. Significant survival differences by race for patients with adenocarcinomas were found at almost all factor levels. Within each racial group, patients with adenocarcinomas had better prognosis than did those with sarcomas. A multivariate analysis found stage of disease and age at diagnosis to be the major predictors of survival among women with adenocarcinomas of the uterine corpus, followed by race, median family income, and mean highest education received. Adjustment of the black survival rates for these factors reduced the gap among patients with adenocarcinomas, but significant differences in survival between blacks and whites remained. Race was not a predictive factor for survival of patients with sarcomas, but age at diagnosis, stage of disease, and education were. After adjustment for the significant factors, prognosis was equally poor for black patients and white patients with sarcomas of the uterine corpus. These findings suggest that, even when controlling for known markers of racial differences, there remain other underlying prognostic factors associated with survival of black women and white women with adenocarcinomas of the uterine corpus that have yet to be determined.
利用美国三个地理区域1973年至1977年诊断的一系列患者,这些地区参与了美国国立癌症研究所的监测、流行病学和最终结果计划,评估了导致子宫体癌白人女性比黑人女性具有生存优势的预后因素。55岁以下、患有I期疾病且生活在社会经济普查区较高区域的女性生存率较高。在几乎所有因素水平上,腺癌患者的种族生存率存在显著差异。在每个种族群体中,腺癌患者的预后优于肉瘤患者。多变量分析发现,疾病分期和诊断时的年龄是子宫体腺癌女性生存的主要预测因素,其次是种族、家庭收入中位数和接受的平均最高教育程度。对这些因素调整黑人的生存率后,腺癌患者之间的差距缩小,但黑人和白人之间的生存差异仍然显著。种族不是肉瘤患者生存的预测因素,但诊断时的年龄、疾病分期和教育程度是。在对显著因素进行调整后,子宫体肉瘤黑人患者和白人患者的预后同样较差。这些发现表明,即使控制了已知的种族差异标志物,仍存在其他与子宫体腺癌黑人女性和白人女性生存相关的潜在预后因素,尚未确定。