在癌症诊断后,黑人和白人生存率
Peter B Bach1, Deborah Schrag, Otis W Brawley
1Health Outcomes Research Group, Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
JAMA
|April 23, 2002
概括
当治疗和阶段相似时,癌症存活率的种族差异是最小的. 癌症生物学上的差异不太可能解释生存差距;相反,专注于治疗和其他健康问题来减少差异.
科学领域:
- 在瘤学瘤学.
- 流行病学 流行病学
- 健康差距 研究 研究 研究 研究
背景情况:
- 与白人相比,在黑人中观察到较低的癌症存活率,为固有生物学差异的理论提供了动力.
- 然而,不同治疗质量和并发症对这些生存差异的影响尚未得到充分研究.
研究的目的:
- 量化黑人和白人患者之间的生存差异,这些患者接受了相应的癌症治疗,治疗了类似的疾病阶段.
- 调查癌症生物学,而不是其他因素,有助于观察到的种族生存差距的程度.
主要方法:
- 在MEDLINE (1966-2002) 的系统文献搜索中,比较黑白癌症患者的存活率与类似治疗的研究.
- 纳入标准:报告至少10名黑人和10名白人患者的研究,可比治疗,经阶段调整的生存数据.
- 用危险比率 (HRs) 调整以非癌症死亡率为准的整体和癌症特异性生存率的元分析.
主要成果:
- 在14种癌症类型中分析了189,877名白人和32,004名黑人患者.
- 与白人患者相比,黑人患者的整体死亡风险略高 (HR=1.16).
- 在对非癌症死亡进行调整后,黑人患者的癌症特异性死亡风险略高 (HR=1.07),仅对乳腺癌,子宫癌和膀癌有意义.
结论:
- 当治疗和阶段相似时,种族群体之间存在适度的癌症特异性生存差异,这表明癌症生物学不是差异的主要驱动因素.
- 治疗中的差异,诊断时的疾病阶段以及其他健康状况的死亡率更有可能解释生存差距.
- 干预措施应针对这些可修改的因素,以有效减少癌症结果差异.
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