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Disparities in breast cancer: a multi‐institutional comparative analysis focusing on American Hispanics

机译:乳腺癌差异:针对美国西班牙裔的多机构比较分析

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摘要

Breast cancer (BC) is the leading cause of cancer death in Hispanic/Latino women nationwide. Hispanic women are more likely to be presented with advanced disease and adverse prognosis subtypes. The aim of this study is to describe the clinico‐ pathological characteristics and disparities in breast cancer in this group at two tertiary care University‐based medical centers. After IRB approval, Cancer registry was used to analyze the variables of 3441 patients with breast cancer diagnosed and treated consecutively at two large tertiary University based medical and cancer center database centers in El Paso, TX and Loma Linda, CA between 2005 and 2015. Association between race/ethnicity and cancer type, stage, hormone receptor status and treatment option were investigated. Overall 45.5% of the patients were Hispanic (n: 1566) and those were more likely to be diagnosed at a younger age (57 years) similar to African Americans, more likely to have invasive ductal carcinoma type (82.7%) & triple negative disease (17.1%, 95%CI: 15% to 19%). 58.8% of Hispanics (95%CI: 56% to 61%) have hormone receptor (HR)+ & HER2− as opposed to 71% in non‐Hispanic White people. In addition, Hispanic individuals presented with advanced stages of BC (25.3%, 95% CI: 23% to 28%) similar to African American (25.4%), and had a lower proportion of lumpectomy (50%) similar to African American (50%). When compared to African American patients, Hispanic patients had a higher prevalence of triple negative BC (17.11% in Hispanics Versus 13.86% in African American). Conclusion: Hispanics had significantly higher relative risk of advanced stages at presentation (Relative Risk Ratio (RRR) = 2.05, P < 0.001), triple negative tumors (RRR = 2.64, P < 0.0001), HER2 + /HR ‐ disease (RRR = 1.77, P < 0.0001), and less HR+ /HER2− BC ( style="fixed-case">RRR = 0.69, P < 0.0001). Hispanics and African Americans are diagnosed with breast cancer at a younger age, have a higher prevalence of Triple negative breast cancer, and are diagnosed at more advanced stages of disease. Increasing awareness and targeting minority populations for health promotion interventions, screening and early detection continue to be of paramount importance to reduce the burden of health disparities.
机译:乳腺癌(BC)是全国西班牙裔/拉丁美洲女性中导致癌症死亡的主要原因。西班牙裔女性更有可能出现晚期疾病和不良预后亚型。这项研究的目的是描述在两个三级护理大学的医学中心该组乳腺癌的临床病理特征和差异。在IRB批准之后,使用癌症注册中心分析了2005年至2015年之间在德克萨斯州埃尔帕索和加利福尼亚州洛马琳达的两个大型大学医疗中心和癌症中心数据库中心连续诊断和治疗的3441例乳腺癌患者的变量。在种族/种族与癌症类型,阶段,激素受体状态和治疗选择之间进行了研究。总体上,有45.5%的患者为西班牙裔(n:1566),与非裔美国人相似,更容易被诊断为年龄较小的年龄(57岁),更可能患有浸润性导管癌类型(82.7%)和三阴性。 (17.1%,95%CI:15%至19%)。 58.8%的西班牙裔(95%CI:56%至61%)具有激素受体(HR)+和HER2-,而非西班牙裔白人则为71%。此外,西班牙裔个体的BC晚期(25.3%,95%CI:23%至28%)与非裔美国人(25.4%)相似,而与非裔美国人相似的乳房切除术比例较低(50%)( 50%)。与非裔美国人患者相比,西班牙裔患者的三阴性BC患病率更高(拉美裔患者为17.11%,非裔美国人为13.86%)。结论:西班牙裔美国人在就诊时具有较高的晚期相对风险(相对风险比(RRR)= 2.05,P <0.001),三阴性肿瘤(RRR = 2.64,P <0.0001),HER2 + / HR疾病(RRR = 1.77,P <0.0001)和更少的HR + / HER2-BC( style =“ fixed-case”> RRR = 0.69,P <0.0001)。西班牙裔美国人和非裔美国人被诊断为较年轻的乳腺癌,三阴性乳腺癌的患病率较高,并且被诊断为疾病的晚期。对于减少健康差距的负担而言,提高认识并针对少数群体进行健康促进干预,筛查和及早发现仍然是最重要的。

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