Frost F, Tollestrup K, Hunt W C, Gilliland F, Key C R, Urbina C E
Institute for Health and Population Research, Lovelace Institutes Albuquerque, New Mexico 87108, USA.
Cancer Epidemiol Biomarkers Prev. 1996 Nov;5(11):861-6.
A study of breast cancer survival was conducted among New Mexico Hispanic and non-Hispanic white women and New Mexico and Arizona American Indian women diagnosed between 1973 and 1992. The goals were to determine whether, after adjusting for first treatment and the extent of disease at diagnosis, American Indian and Hispanic women had poorer survival than non-Hispanic whites and, if survival had improved over time, whether comparable improvements had been made for the three racial/ethnic groups. Five-year relative survival rates were calculated, and a Cox proportional hazards model was constructed to compare survival between races/ethnicities, adjusting for first treatment and the extent of disease at diagnosis. Findings indicate that during 1983-1992, breast cancer was more commonly detected at a local stage for all three groups compared to 1973-1982. Five-year relative survival improved for non-Hispanic white and American Indian women with local or regional disease, but the improvement was statistically significant only for non-Hispanic white women and for American Indian women with local disease. Despite earlier stages at diagnosis, Hispanic females showed less improvement in overall or stage-specific survival than non-Hispanic whites. The Cox model indicated that American Indian women experienced poorer survival than non-Hispanic whites during both time periods. Survival of Hispanic women with breast cancer was comparable to non-Hispanic whites during 1973-1982 but was significantly worse during 1983-1992. The significance of this lower survival is amplified by increasing breast cancer incidence among New Mexico Hispanics and American Indians.
一项针对乳腺癌生存率的研究在新墨西哥州的西班牙裔和非西班牙裔白人女性以及新墨西哥州和亚利桑那州1973年至1992年间被诊断出患乳腺癌的美国印第安女性中开展。研究目的是确定在调整了首次治疗和诊断时疾病的严重程度后，美国印第安女性和西班牙裔女性的生存率是否低于非西班牙裔白人女性；以及如果生存率随时间有所提高，这三个种族/族裔群体的改善情况是否相当。计算了五年相对生存率，并构建了Cox比例风险模型，以比较不同种族/族裔之间的生存率，同时调整首次治疗和诊断时疾病的严重程度。研究结果表明，与1973 - 1982年相比，在1983 - 1992年期间，所有三个群体在局部阶段更常检测出乳腺癌。局部或区域疾病的非西班牙裔白人和美国印第安女性的五年相对生存率有所提高，但仅非西班牙裔白人女性以及患有局部疾病的美国印第安女性的改善具有统计学意义。尽管诊断时处于更早阶段，但西班牙裔女性在总体生存率或特定阶段生存率方面的改善低于非西班牙裔白人女性。Cox模型表明，在两个时间段内，美国印第安女性的生存率均低于非西班牙裔白人女性。1973 - 1982年期间，患有乳腺癌的西班牙裔女性的生存率与非西班牙裔白人女性相当，但在1983 - 1992年期间则显著更差。新墨西哥州西班牙裔和美国印第安人乳腺癌发病率的上升加剧了这种较低生存率的显著性。
