中国一项长达 9 年的回顾性队列研究显示，蒙古族乳腺癌患者的疾病负担更高，利用度更低：涉及 1819 万成年人。

Higher disease burden and lower utilization in Mongolian with breast cancer: a 9-year retrospective cohort study of 18.19 million adults in China.

机构信息

School of Health Humanities, Peking University.

Inner Mongolia Autonomous Region Center for Disease Control and Prevention (Inner Mongolia Autonomous Region Academy of Preventive Medicine).

出版信息

Int J Surg. 2024 Aug 1;110(8):4588-4597. doi: 10.1097/JS9.0000000000001478.

DOI:10.1097/JS9.0000000000001478

PMID:38608032

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11325962/

Abstract

BACKGROUND

Whether health inequalities of disease burden and medical utilization exist by ethnicity in Asian breast cancer (BC) patients remains unclear. The authors aim to measure ethnic disparities in disease burden and utilization among Mongolian and Han female BC patients in China.

MATERIALS AND METHODS

Based on data extracted from Inner Mongolia Regional Health Information Platform, a retrospective cohort study was established during 2012-2021. Disease burden including incidence, 5-year prevalence, mortality, survival rate, and medical cost were analyzed and compared between Han and Mongolian patients.

RESULTS

A total of 34 878 female patients [mean (SD) age, 52.34 (10.93) years] were included among 18.19 million Chinese, and 4315 (12.03%) participants were Mongolian. Age-standardized rates of incidence are 32.68 (95% CI: 20.39-44.98) per 100 000. Higher age-specific incidence and 5-year prevalence were observed in Mongolian than in Han. The cost of BC annually per capita was significantly lower for Mongolian than Han [$1948.43 (590.11-4 776.42) vs. $2227.35 (686.65-5929.59), P <0.001]. Mongolian females showed higher all-cause mortality [30.92 (95% CI: 28.15-33.89) vs. 27.78 (95% CI: 26.77-28.83) per 1000, P =0.036] and BC-specific mortality [18.78 (95% CI: 16.64-21.13) vs. 15.22 (95% CI: 14.47-16.00) per 1000, P =0.002] than Han females. After adjusting covariates, Mongolian were associated with increased all-cause mortality [HR, 1.21, (95% CI: 1.09-1.34); P <0.001] and BC-specific mortality [HR, 1.31, (95% CI: 1.14-1.49); P <0.001].

CONCLUSION

The findings of this cohort study highlight a higher level of disease burden with unmet medical demand in Mongolian patients, suggesting that more practical efforts should be made for the minority. Further research is needed to explore the concrete mechanisms of the disparities as well as eliminate health disproportion.

摘要

背景

亚洲乳腺癌（BC）患者的疾病负担和医疗利用是否存在种族差异尚不清楚。作者旨在测量中国蒙古族和汉族 BC 女性患者在疾病负担和利用方面的种族差异。

材料和方法

基于从内蒙古地区卫生信息平台提取的数据，建立了一项回顾性队列研究，研究时间为 2012 年至 2021 年。分析并比较了汉族和蒙古族患者的疾病负担，包括发病率、5 年患病率、死亡率、生存率和医疗费用。

结果

在 1819 万中国人群中，共纳入 34878 名女性患者（平均[标准差]年龄为 52.34[10.93]岁），其中 4315 名（12.03%）为蒙古族。发病率的年龄标准化率为 32.68（95%可信区间：20.39-44.98）/100000。蒙古族患者的年龄特异性发病率和 5 年患病率均高于汉族患者。蒙古族 BC 患者的人均年度医疗费用明显低于汉族患者[1948.43 美元（95%可信区间：590.11-4776.42）与 2227.35 美元（95%可信区间：686.65-5929.59），P <0.001]。蒙古族女性的全因死亡率[30.92（95%可信区间：28.15-33.89）与 27.78（95%可信区间：26.77-28.83）/1000，P =0.036]和 BC 特异性死亡率[18.78（95%可信区间：16.64-21.13）与 15.22（95%可信区间：14.47-16.00）/1000，P =0.002]均高于汉族女性。调整协变量后，蒙古族女性全因死亡率[风险比，1.21（95%可信区间：1.09-1.34）；P <0.001]和 BC 特异性死亡率[风险比，1.31（95%可信区间：1.14-1.49）；P <0.001]的风险均增加。