Breast carcinoma survival analysis for african american and white women in an equal-access health care system†

摘要: BACKGROUND This retrospective review of breast carcinoma cases in the Department Defense (DoD) Central Tumor Registry evaluated differences survival patterns between African American and white women treated U.S. military health care facilities. The study examined effects age, stage cancer, tumor size, grade, lymph node involvement, waiting time diagnosis first treatment, marital status, dependent alcohol usage, tobacco family history cancer. METHODS Researchers reviewed registry records 6577 (5879 whites 698 Americans) diagnosed with carcinoma. patients, ages 19-97 years, were 1975 1994. A hazard ratio (relative risk mortality) model compared adjusting for various combinations covariates; impact independent variables on death; prognostic factors significantly associated survival; disease free overall times; ethnicity, stage, age trends at diagnosis. P value (2-sided) less than 0.05 was considered statistically significant. RESULTS After adjustment death 1.45 (95% confidence interval [CI], 1.20-1.76) times greater women. Adjustment reduced to 1.41 CI, 1.16-1.70); further demographic most clinical had no effect. Still, facilities a better rate represented Surveillance, Epidemiology, End Results (SEER) Program National Cancer Institute. In our study, 5-year death, from any cause, 1.37 carcinoma; other words, mortality 24.77% 18.08% latest SEER data, relative is 1.86. 34.2% 18.4% DoD beneficiaries comparable that SEER. CONCLUSIONS These observations suggest ready access medical full complement treatment options are standard all patients improve rates However, significant unexplained difference still exists beneficiaries. 1998;82:1310-8. © 1998 Society.