Hicks M L, Phillips J L, Parham G, Andrews N, Jones W B, Shingleton H M, Menck H R
Department of Obstetrics and Gynecology, Henry Ford Hospital, Detroit, Michigan, USA.
Cancer. 1998 Dec 15;83(12):2629-37. doi: 10.1002/(SICI)1097-0142(19981215)83:12<2629::AID-CNCR30>3.0.CO;2-2.
Although the incidence of uterine carcinoma is lower among African-American women compared with white women, the mortality rates are higher for African-American patients. This report is part of an ongoing series on gynecologic malignancies in African-American women.
Hospital registry reports collected by the National Cancer Data Base were used to describe some of the differences in case presentation and management characteristics of endometrial carcinoma in these two groups. The cases represented 52,307 Non-Hispanic white and 3226 African-American women diagnosed with primary carcinoma of the endometrium between 1988-1994.
More African-American patients were diagnosed with less favorable histologies than white patients, at more advanced stages of disease, and with less tumor differentiation. Income had no effect on stage or grade. African-American patients were treated less often for their tumor at every stage of diagnosis compared with white women. Income generally had no effect on whether treatment was provided, but limited income was associated with a lack of treatment in African-American patients with American Joint Committee on Cancer Stage IV tumors. African-American women were less frequently treated surgically and, among surgically treated patients at advanced stages of disease, they received adjuvant radiotherapy less often and chemotherapy more often than white patients. Five-year survival was poorer for African-American women, even for patients with the more favorable Stage I adenocarcinoma who were treated surgically.
All patients, regardless of race, should be treated appropriately as dictated by medical and prognostic factors and not by race. Although no screening methods currently exist for endometrial carcinoma, the development of procedures for identifying patients at risk for the prognostic factors that lead to a poor outcome should be a primary focus.
尽管与白人女性相比，非裔美国女性子宫癌的发病率较低，但非裔美国患者的死亡率更高。本报告是关于非裔美国女性妇科恶性肿瘤系列研究的一部分。
利用国家癌症数据库收集的医院登记报告来描述这两组子宫内膜癌病例在临床表现和治疗特征方面的一些差异。这些病例代表了1988年至1994年间被诊断为原发性子宫内膜癌的52307名非西班牙裔白人女性和3226名非裔美国女性。
与白人患者相比，更多的非裔美国患者被诊断为组织学类型较差、疾病分期较晚且肿瘤分化程度较低。收入对疾病分期或分级没有影响。与白人女性相比，在每个诊断阶段，非裔美国患者接受肿瘤治疗的频率较低。收入一般对是否接受治疗没有影响，但收入有限与美国癌症联合委员会IV期肿瘤的非裔美国患者未接受治疗有关。非裔美国女性接受手术治疗的频率较低，在疾病晚期接受手术治疗的患者中，她们接受辅助放疗的频率低于白人患者，而接受化疗的频率高于白人患者。非裔美国女性的五年生存率较低，即使是接受手术治疗的I期腺癌预后较好的患者也是如此。
所有患者，无论种族如何，都应根据医学和预后因素进行适当治疗，而不是根据种族。尽管目前尚无子宫内膜癌的筛查方法，但开发用于识别具有导致不良预后的预后因素风险的患者的程序应成为主要重点。
