转移性乳腺癌患者的生存差异
Koumani W Ntowe1, Samantha M Thomas2,3, Marguerite M Rooney1
1Department of Surgery, Duke University Medical Center, Durham, NC.
JCO oncology practice
|January 21, 2026
概括
在新的转移性乳腺癌 (dnMBC) 存活率方面,种族和保险差异仍然存在. 非西班牙裔黑人和没有保险的患者面临着明显更糟糕的结果,突出了改善医疗保健准入和系统变革的需要.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 流行病学 流行病学
背景情况:
- 新发性转移性乳腺癌 (dnMBC) 的预后通常是致命的.
- 最近的治疗进展改善了生存率,但公平的利益分配是不确定的.
- 基于种族/种族和保险状况的结果差异是一个重大问题.
研究的目的:
- 评估种族/种族和保险状况与 dnMBC 患者的生存结果之间的关联.
- 为了确定特定的种族/民族和保险群体,生存率较差.
- 了解生存率的改善是否在平等地达到所有dnmbc患者群体.
主要方法:
- 从SEER数据库分析了1988年至2016年间被诊断患有dnMBC的47034名患者.
- 按种族/种族 (NHW,NHB,NHO,西班牙裔) 和保险状况 (私人/医疗保险,医疗补助,无保险) 的分层.
- 总生存率 (OS) 和癌症特异性生存率的估计,使用多变量模型进行调整分析.
主要成果:
- 非西班牙裔黑人 (NHB) 患者和没有保险的患者的平均寿命最差 (分别为21个月和22个月).
- 在调整后,NHB患者 (HR 1.24) 和无保险患者 (HR 1.29) 与NHW和有保险患者相比,他们的生存状况明显更差.
- 虽然所有群体的生存率随着时间的推移而有所改善,但观察到持续的差异.
结论:
- 在dnMBC存活率方面,仍然存在显著的种族/民族和与保险相关的差异.
- 非西班牙裔黑人和没有保险的个人经历了明显更糟糕的结果.
- 改善医疗保健准入和解决超出保险范围的系统因素对于实现所有dnMBC患者公平生存至关重要.
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