黑人和白人乳腺癌患者之间的并发症和生存差异
C Martin Tammemagi1, David Nerenz, Christine Neslund-Dudas
1Department of Community Health Sciences, Brock University, St Catharines, Ontario, Canada. martin.tammemagi@brocku.ca
JAMA
|October 13, 2005
概括
黑人乳腺癌患者的存活时间较短,原因是伴随性疾病,特别是糖尿病和高血压的发病率较高. 管理这些疾病对于改善预期寿命和减少乳腺癌发病率的种族差异至关重要.
科学领域:
- 在瘤学瘤学.
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 乳腺癌存活率的种族差异仍然存在,与白人患者相比,黑人患者表现较差.
- 这种生存差距的根本原因仍然不完全理解.
- 伴随性疾病是导致乳腺癌存活率种族差异的一个潜在因素.
研究的目的:
- 研究伴随性疾病在乳腺癌存活率的种族差异中的作用.
- 量化并发病对黑人与白人乳腺癌患者全因,乳腺癌特异性和异因死亡率的影响.
主要方法:
- 1985-1990年亨利·福特医疗系统对906名乳腺癌患者 (264名黑人,642名白人) 的历史队列研究.
- 详细的并发病数据 (268种疾病) 从医疗记录和注册表中抽取.
- 后勤和考克斯回归分析用于评估并发症和生存结果之间的关联.
主要成果:
- 黑人患者的全因,乳腺癌特异性和竞争性原因生存率明显下降.
- 在黑人患者 (86.0%) 与白人患者 (65.7%) 相比,观察到更高的不良并发症患病率.
- 不良并发症解释了生存差异的很大一部分,特别是在竞争性原因死亡率 (76.7%),糖尿病和高血压是关键因素.
结论:
- 黑人乳腺癌患者更有可能死于其他原因,而不是因为乳腺癌本身.
- 对糖尿病和高血压等并发症的有效管理对于改善存活率和减少乳腺癌的种族差异至关重要.
- 解决黑人乳腺癌患者的并发症负担可以提高预期寿命并减轻生存差距.
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