Simon M S, Severson R K
Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA.
Am J Obstet Gynecol. 1997 Jun;176(6):S233-9. doi: 10.1016/s0002-9378(97)70381-8.
Our purpose was to evaluate the effect of sociodemographic and clinical variables on survival rates of African-American and white women with breast cancer.
Between 1988 and 1992 the Metropolitan Detroit Cancer Surveillance System Identified 10,502 women (82% white and 18% African-American) in whom invasive breast cancer was diagnosed. Cox proportional hazards regression was used to estimate the relative risk of death for African-Americans compared with whites after controlling for variables believed to influence survival.
African-American women were more likely than white women to have tumors that were of a more advanced stage, a higher grade, and hormone receptor-negative. After controlling for age, tumor size, stage, histologic grade, census-derived socioeconomic status, and the presence of a residency training program at the treatment hospital, the relative risk of dying for African-Americans compared with whites was 1.68 (95% confidence interval, 1.27-2.23) for women less than 50 years of age, and 1.33 (95% confidence interval, 1.13-1.56) for women older than 50 years of age.
Known factors that predict survival differences between African-Americans and whites are more prevalent among women less than 50 years of age, emphasizing the need to focus more attention on public health efforts directed toward younger women.
我们的目的是评估社会人口统计学和临床变量对非裔美国人和白人乳腺癌女性生存率的影响。
1988年至1992年间，底特律大都会癌症监测系统识别出10502名被诊断为浸润性乳腺癌的女性（82%为白人，18%为非裔美国人）。在控制了被认为会影响生存的变量后，使用Cox比例风险回归来估计非裔美国人与白人相比的相对死亡风险。
与白人女性相比，非裔美国女性的肿瘤更有可能处于更晚期、更高分级且激素受体阴性。在控制了年龄、肿瘤大小、分期、组织学分级、人口普查得出的社会经济地位以及治疗医院是否存在住院医师培训项目后，50岁以下女性中非裔美国人与白人相比的相对死亡风险为1.68（95%置信区间，1.27 - 2.23），50岁以上女性为1.33（95%置信区间，1.13 - 1.56）。
预测非裔美国人和白人之间生存差异的已知因素在50岁以下女性中更为普遍，这强调了需要更加关注针对年轻女性的公共卫生工作。
