两家公立医院中乳腺癌患者的种族、收入与生存率

Race, income, and survival from breast cancer at two public hospitals.

作者信息

Ansell D, Whitman S, Lipton R, Cooper R

机构信息

Department of Medicine, Cook County Hospital, Chicago, IL 60612.

出版信息

Cancer. 1993 Nov 15;72(10):2974-8. doi: 10.1002/1097-0142(19931115)72:10<2974::aid-cncr2820721019>3.0.co;2-m.

DOI:10.1002/1097-0142(19931115)72:10<2974::aid-cncr2820721019>3.0.co;2-m

PMID:8221564

Abstract

BACKGROUND

Some studies have shown that adjustment for socioeconomic status reduces breast cancer survival differences between blacks and whites. The purpose of this study is to evaluate the effect of age, race, stage, treatment, and income status on breast cancer survival among women attending public hospitals in Chicago, Illinois.

METHODS

Hospital Cancer Registry data on 887 black women and 265 white women with breast cancer onset between 1973-1985 were analyzed using Cox regression and Kaplan-Meier techniques. The purpose was to examine the effect of age, race, stage, treatment, and income on breast cancer survival.

RESULTS

Black women with breast cancer were younger and poorer than white women with breast cancer. There were no significant differences between blacks and whites with regard to stage, estrogen receptor status, or type of treatment. Black women had lower 5-year breast cancer survival rates compared to white women (50.2% versus 60.2%; P = 0.05), and survival was lower when adjusted for stage and age. However, when adjusted for income in addition to stage and age, the effect of race on survival was reduced (from relative risk = 1.26; 95% confidence interval = 1.02, 1.57 to relative risk = 1.17%; 95% confidence interval = 0.95, 1.38).

CONCLUSIONS

Income influences breast cancer survival differences between blacks and whites in this population.

摘要

背景

一些研究表明，对社会经济地位进行调整可缩小黑人和白人之间乳腺癌生存率的差异。本研究的目的是评估年龄、种族、分期、治疗及收入状况对伊利诺伊州芝加哥公立医院就诊女性乳腺癌生存率的影响。

方法

采用Cox回归和Kaplan-Meier技术分析了1973年至1985年间发病的887名黑人女性和265名白人女性乳腺癌患者的医院癌症登记数据。目的是研究年龄、种族、分期、治疗及收入对乳腺癌生存率的影响。

结果

患有乳腺癌的黑人女性比白人女性更年轻且更贫困。黑人和白人在分期、雌激素受体状态或治疗类型方面无显著差异。与白人女性相比，黑人女性的5年乳腺癌生存率较低（50.2%对60.2%；P = 0.05），在根据分期和年龄进行调整后生存率更低。然而，在根据分期和年龄进行调整的基础上再根据收入进行调整后，种族对生存率的影响有所降低（相对风险从1.26；95%置信区间=1.02, 1.57降至相对风险=1.17%；95%置信区间=0.95, 1.38）。