乳腺癌治疗延迟与西班牙裔悖论：一项监测、流行病学和最终结果（SEER）数据库分析。
Breast cancer treatment delay and the Hispanic paradox: A SEER database analysis.
作者信息
Roldan-Vasquez Estefania, Mitri Samir, Brantley Kristen D, James Ted A, Schlam Ilana
机构信息
Breast Surgical Oncology, Department of Surgery. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Breast Surgical Oncology, Department of Surgery. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
出版信息
Am J Surg. 2025 Jun;244:116135. doi: 10.1016/j.amjsurg.2024.116135. Epub 2024 Dec 15.
BACKGROUND
Breast cancer (BC) is the most common cancer in US women. Knowledge gaps exist regarding healthcare inequities in Hispanic BC patients. This study assessed BC characteristics and treatment patterns among Hispanics.
METHODS
Hispanic and non-Hispanic white women (NHW) with invasive BC from the SEER Database (2018-2020) were included. We evaluated if Hispanic ethnicity was associated with time from diagnosis to treatment (TT) and its impact on cancer-specific survival. Treatment delay was defined as > 3 months post-diagnosis. Logistic regression, Kaplan-Meier curves, and Cox regression models were used.
RESULTS
Among 135,690 patients, 16.5 % were Hispanic. Median TT for Hispanics was 1.5 ÷ 1.34 months vs. 1.22 ÷ 1.07 months for NHW (p < 0.001). Adjusted analysis showed Hispanics had 2.47 times higher odds of delayed TT than NHW (95 % CI: 2.29-2.66). Delayed TT worsened survival in both groups; however, within the delayed TT, Hispanics had better survival (HR: 0.52, 95 % Cl: 0.27-0.98, p = 0.045).
CONCLUSIONS
Disparities in healthcare for Hispanic patients exist; targeted interventions and public health initiatives are needed to ensure equitable care.
背景
乳腺癌（BC）是美国女性中最常见的癌症。西班牙裔乳腺癌患者在医疗保健公平性方面存在知识差距。本研究评估了西班牙裔人群的乳腺癌特征和治疗模式。
方法
纳入了来自监测、流行病学和最终结果（SEER）数据库（2018 - 2020年）的患有浸润性乳腺癌的西班牙裔和非西班牙裔白人女性（NHW）。我们评估了西班牙裔种族是否与从诊断到治疗的时间（TT）相关及其对癌症特异性生存的影响。治疗延迟定义为诊断后超过3个月。使用了逻辑回归、Kaplan - Meier曲线和Cox回归模型。
结果
在135,690名患者中，16.5%为西班牙裔。西班牙裔的中位TT为1.5÷1.34个月，而非西班牙裔白人女性为1.22÷1.07个月（p < 0.001）。调整分析显示，西班牙裔延迟TT的几率比非西班牙裔白人女性高2.47倍（95%CI：2.29 - 2.66）。延迟TT在两组中均使生存率恶化；然而，在延迟TT的患者中，西班牙裔的生存率更高（风险比：0.52；95%CI：0.27 - 0.98；p = 0.045）。
结论
西班牙裔患者在医疗保健方面存在差异；需要有针对性的干预措施和公共卫生举措来确保公平的医疗服务。
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