Franzini L, Williams A F, Franklin J, Singletary S E, Theriault R L
Health Policy Institute, University of Texas School of Public Health, Houston 77030, USA.
Ann Surg Oncol. 1997 Mar;4(2):111-8. doi: 10.1007/BF02303792.
A survival disadvantage for black women with breast cancer, which persists after controlling for stage of the disease, has been reported. This study investigates the effects of race and socioeconomic status (SES) on breast cancer survival after controlling for age, stage, histology, and type of treatment.
Kaplan-Meier and Cox proportional hazards models were used to analyze the interaction between race and SES in predicting survival in a sample of 163 black, 205 Hispanic and 964 white women with breast cancer treated at M.D. Anderson Cancer Center a (1987-1991).
The results of univariate and multivariate analyses indicate that race was not a significant predictor of survival after adjusting for SES and other confounding factors such as demographic and disease characteristics. SES remained a significant predictor of survival after all adjustments were made. There was no evidence of differences in type of treatment by race or SES if adjustments were made for stage.
These results suggest that institutional factors, such as access to treatment, do not explain survival differences by race or SES. Other factors associated with low SES, such as life-style and behavior, may affect survival.
据报道，患有乳腺癌的黑人女性存在生存劣势，即便在控制疾病分期后这种劣势依然存在。本研究在控制年龄、分期、组织学类型和治疗方式后，调查种族和社会经济地位（SES）对乳腺癌生存的影响。
采用Kaplan-Meier法和Cox比例风险模型，分析在MD安德森癌症中心接受治疗的163名黑人、205名西班牙裔和964名白人乳腺癌女性样本中，种族与SES在预测生存方面的相互作用（1987 - 1991年）。
单因素和多因素分析结果表明，在调整SES及其他混杂因素（如人口统计学和疾病特征）后，种族并非生存的显著预测因素。在进行所有调整后，SES仍是生存的显著预测因素。如果对分期进行调整，未发现种族或SES在治疗方式上存在差异的证据。
这些结果表明，诸如获得治疗机会等机构因素并不能解释种族或SES导致的生存差异。与低SES相关的其他因素，如生活方式和行为，可能会影响生存。
