Roach M, Alexander M
Dept of Radiation Oncology, University of California, San Francisco 94143-0226, USA.
J Natl Med Assoc. 1995 Mar;87(3):214-9.
For more than 20 years, black women with breast cancer have been reported to have a lower survival rate than white women with breast cancer. Despite correcting for stage and socioeconomic status, some studies continue to report race-related excess mortality. A reliability scoring system was developed, based primarily on the precision of the staging system used, and the likelihood that the quality of treatment was comparable. Studies that compared the survival of blacks and whites treated for breast cancer from 1968 to 1988 were included in this study. Studies that demonstrated relatively large differences in the 5-year survival between blacks and whites were associated with low reliability scores. Studies that reported little or no difference in 5-year survival rates were associated with relatively high reliability scores. This model and the literature on which it is based suggest that the reported survival differences associated with race can be explained by differences in stage at presentation and by differences in the quality of care received. Efforts directed at early detection and improvements in the quality of care delivered are likely to reduce the excess breast cancer mortality experienced by black women.
20多年来，据报道，患有乳腺癌的黑人女性的生存率低于患有乳腺癌的白人女性。尽管对疾病分期和社会经济地位进行了校正，但一些研究仍继续报告与种族相关的超额死亡率。开发了一种可靠性评分系统，主要基于所使用的分期系统的精确性以及治疗质量具有可比性的可能性。本研究纳入了1968年至1988年期间比较接受乳腺癌治疗的黑人和白人患者生存率的研究。那些显示黑人和白人5年生存率存在相对较大差异的研究，其可靠性评分较低。那些报告5年生存率几乎没有差异或没有差异的研究，其可靠性评分相对较高。该模型及其所依据的文献表明，所报告的与种族相关的生存差异可以通过就诊时的分期差异以及所接受护理质量的差异来解释。针对早期检测和提高所提供护理质量的努力，可能会降低黑人女性所经历的超额乳腺癌死亡率。
