Division of Medical and Population Health Sciences Education and Research, Department of Medical Education, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA.
Escuela Superior de Medicina, Universidad Nacional de Mar del Plata, Mar del Plata 7600, Argentina.
Int J Environ Res Public Health. 2023 Sep 12;20(18):6742. doi: 10.3390/ijerph20186742.
While there may be an association between race, tumor size, and survival in patients with cervical squamous cell carcinoma (SCC), evidence on the effect of race on the association between tumor size at diagnosis and survival is limited. Our study evaluated whether race modifies the association between tumor size and 10-year survival in cervical SCC.
This non-concurrent cohort study with the Surveillance, Epidemiology, and End Results (SEER) database included women diagnosed with cervical SCC between 2004-2018. The independent variable was diagnosis tumor size, where 2-4 cm was classified as high risk, and <2 cm was considered low risk. The dependent variable was 10-year cancer-specific survival rates, and race was our effect modifier. Unadjusted and adjusted Cox regression analysis were conducted to calculate hazard ratios (HR) and 95% confidence intervals (CI).
While a higher proportion of Black/Asian/Pacific Islander patients presented with tumor sizes of 2-4 cm compared to <2 cm (32.8% vs. 22.3%; = 0.007) and having a tumor size of 2-4 cm had a significantly decreased 10-year survival (HR: 2.7; 95% CI: 1.3-5.8), the interaction between race and 10-year cancer-specific survival was not significant.
Although race did not modify the interaction between tumor size and 10-year survival, emphasis needs to be placed on screening and proper data collection, especially for minority races, and studies with larger sample sizes should be conducted in order to better implement future recommendations to improve health and survival.
在患有宫颈鳞状细胞癌 (SCC) 的患者中，种族、肿瘤大小和生存之间可能存在关联，但关于种族对诊断时肿瘤大小与生存之间关联的影响的证据有限。我们的研究评估了种族是否改变了肿瘤大小与宫颈 SCC10 年生存率之间的关联。
这项具有监测、流行病学和最终结果 (SEER) 数据库的非同期队列研究纳入了 2004 年至 2018 年间诊断为宫颈 SCC 的女性。自变量是诊断时的肿瘤大小，其中 2-4cm 被归类为高危，<2cm 被认为是低危。因变量是 10 年癌症特异性生存率，种族是我们的效应修饰剂。进行了未调整和调整后的 Cox 回归分析，以计算风险比 (HR) 和 95%置信区间 (CI)。
与<2cm 的肿瘤大小相比，黑/亚洲/太平洋岛民患者的肿瘤大小为 2-4cm 的比例更高 (32.8% vs. 22.3%；=0.007)，且肿瘤大小为 2-4cm 的患者 10 年生存率显著降低 (HR：2.7；95%CI：1.3-5.8)，但种族与 10 年癌症特异性生存率之间的交互作用并不显著。
尽管种族没有改变肿瘤大小与 10 年生存率之间的交互作用，但需要特别重视筛查和适当的数据收集，特别是对少数民族，并且应该进行更大样本量的研究，以便更好地实施未来的建议，以改善健康和生存。
