Department of Internal Medicine, Crozer-Chester Medical Center, 1 Medical Center Blvd, Upland, PA, USA.
Department of Palliative Care, Einstein Medical Center, Philadelphia, PA, USA.
Med Oncol. 2023 Jun 22;40(7):210. doi: 10.1007/s12032-023-02083-w.
Breast cancer is the second most diagnosed malignancy in American women with a lifetime occurrence of 1 in 8 women in the United States. There has been a dearth of research focusing on regional differences in breast cancer mortality with respect to race in the US. It is crucial to identify regions that are lagging to uplift the outreach of breast cancer care to certain races. Data for this study were obtained from the 2016-2018 Nationwide Inpatient Sample. In-hospital mortality, race and hospital regions for the patients with the primary diagnosis of Malignant Neoplasms of Breast were studied. Baseline characteristics of participants were summarized using descriptive statistics. The patient population was stratified as per race, hospital region, gender, therapy received and family history. Logistic regression was performed to derive the odds ratio while adjusting for different variables. 99, 543 patients with metastatic breast cancer were identified. African Americans (AAs) were found to have the highest reported deaths at 5.54%, followed by Asians and Pacific Islanders at 4.80% and Caucasians 4.09% (p < 0.0001). The odds of dying were significantly higher in the AA population when compared to Caucasian population (OR 1.391 (1.286-1.504)), and the odds were consistently higher across all regions of the US. In terms of regional disparities with respect to race, AA's had highest mortality in the south whereas all other races had the highest mortality in the west. It was seen that races identifying as "others" had significantly higher odds of dying in the Northeast. It is crucial to identify racial differences in the various regions across the US in order to implement appropriate outreach strategies to tackle these disparities.
乳腺癌是美国女性中第二大常见的恶性肿瘤，美国每 8 名女性中就有 1 人会在一生中患上乳腺癌。关于美国种族与乳腺癌死亡率的区域性差异，相关研究很少。确定落后地区对于提高某些种族的乳腺癌护理服务的普及度至关重要。本研究的数据来自 2016-2018 年全国住院患者样本。研究了患有乳腺恶性肿瘤的患者的住院死亡率、种族和医院所在地区。使用描述性统计方法总结参与者的基本特征。根据种族、医院所在地区、性别、接受的治疗和家族史对患者人群进行分层。通过逻辑回归得出调整不同变量后的优势比。共确定了 99,543 例转移性乳腺癌患者。非裔美国人（AAs）的死亡率最高，为 5.54%，其次是亚裔和太平洋岛民，为 4.80%，白种人 4.09%（p<0.0001）。与白种人相比，AAs 死亡的几率明显更高（OR 1.391（1.286-1.504）），而且这种几率在美国所有地区都一致更高。在种族与地区差异方面，AAs 在南部的死亡率最高，而其他所有种族在西部的死亡率最高。在东北部，其他种族的死亡率明显更高。为了解决这些差异，有必要确定美国不同地区的种族差异，以便实施适当的外展策略。
