PDF(Pubmed)
Abstract：
BACKGROUND: In general, migrant women have a lower breast cancer (BC) incidence rate and higher BC mortality than autochthonous women. Further, migrant women show lower participation in the national BC screening program. To further investigate those aspects, we aimed to determine differences in incidence and tumor characteristics between autochthonous and migrant BC patients in Rotterdam, the Netherlands.
METHODS: We selected women diagnosed with BC in Rotterdam during 2012-2015 from the Netherlands Cancer Registry. Incidence rates were calculated by migrant status (i.e., women with or without migration background). Multivariable analyses revealed adjusted odds ratios (OR) and 95% confidence intervals (CI) on the association between migration status and patient and tumor characteristics, additionally stratified by screening attendance (yes/no).
RESULTS: In total 1372 autochthonous and 450 migrant BC patients were included for analysis. BC incidence was lower among migrants than among autochthonous women. Overall, migrant women were younger at BC diagnosis (53 vs. 64 years, p < 0.001), and had higher risks of positive lymph nodes (OR 1.76, 95% CI 1.33-2.33) and high grade tumors (OR 1.35, 95% CI 1.04-1.75). Especially non-screened migrant women had higher risk of positive nodes (OR 2.73, 95% CI 1.43-5.21). Among the subgroup of screened women, we observed no significant differences between migrant and autochthonous patients.
CONCLUSIONS: Migrant women have lower BC incidence than autochthonous women, but diagnosis was more often at younger age and with unfavorable tumor characteristics. Attending the screening program strongly reduces the latter. Therefore, promotion of participation in the screening program is recommended.
METHODS: We selected women diagnosed with BC in Rotterdam during 2012-2015 from the Netherlands Cancer Registry. Incidence rates were calculated by migrant status (i.e., women with or without migration background). Multivariable analyses revealed adjusted odds ratios (OR) and 95% confidence intervals (CI) on the association between migration status and patient and tumor characteristics, additionally stratified by screening attendance (yes/no).
RESULTS: In total 1372 autochthonous and 450 migrant BC patients were included for analysis. BC incidence was lower among migrants than among autochthonous women. Overall, migrant women were younger at BC diagnosis (53 vs. 64 years, p < 0.001), and had higher risks of positive lymph nodes (OR 1.76, 95% CI 1.33-2.33) and high grade tumors (OR 1.35, 95% CI 1.04-1.75). Especially non-screened migrant women had higher risk of positive nodes (OR 2.73, 95% CI 1.43-5.21). Among the subgroup of screened women, we observed no significant differences between migrant and autochthonous patients.
CONCLUSIONS: Migrant women have lower BC incidence than autochthonous women, but diagnosis was more often at younger age and with unfavorable tumor characteristics. Attending the screening program strongly reduces the latter. Therefore, promotion of participation in the screening program is recommended.
摘要：
背景：一般来说，与本土女性相比,移民女性乳腺癌(BC)发病率较低,BC死亡率较高.Further,移民妇女在国家BC筛查计划中的参与度较低。为了进一步调查这些方面，我们旨在确定鹿特丹本地和移民BC患者之间的发病率和肿瘤特征的差异，荷兰。
方法：我们从荷兰癌症登记处选择了2012-2015年在鹿特丹诊断为BC的女性。发病率按移民身份计算(即，有或没有移民背景的女性)。多变量分析揭示了迁移状态与患者和肿瘤特征之间的关联的调整比值比（OR）和95％置信区间（CI）。额外按筛查出勤率分层（是/否）。
结果：共纳入1372名自体和450名移民BC患者进行分析。移民中的BC发病率低于本地妇女。总的来说,移民妇女在BC诊断时更年轻(53vs.64年,p<0.001)，淋巴结阳性(OR1.76,95%CI1.33-2.33)和高级别肿瘤(OR1.35,95%CI1.04-1.75)的风险较高。特别是未筛查的移民妇女具有更高的阳性节点风险（OR2.73，95％CI1.43-5.21）。在接受筛查的女性亚组中，我们观察到移民和本地患者之间没有显着差异。
结论：移民妇女的BC发病率低于本土妇女，但诊断更多发生在年龄较小并且具有不利的肿瘤特征.参加筛选程序会大大减少后者。因此,建议促进参与筛选计划。
方法：我们从荷兰癌症登记处选择了2012-2015年在鹿特丹诊断为BC的女性。发病率按移民身份计算(即，有或没有移民背景的女性)。多变量分析揭示了迁移状态与患者和肿瘤特征之间的关联的调整比值比（OR）和95％置信区间（CI）。额外按筛查出勤率分层（是/否）。
结果：共纳入1372名自体和450名移民BC患者进行分析。移民中的BC发病率低于本地妇女。总的来说,移民妇女在BC诊断时更年轻(53vs.64年,p<0.001)，淋巴结阳性(OR1.76,95%CI1.33-2.33)和高级别肿瘤(OR1.35,95%CI1.04-1.75)的风险较高。特别是未筛查的移民妇女具有更高的阳性节点风险（OR2.73，95％CI1.43-5.21）。在接受筛查的女性亚组中，我们观察到移民和本地患者之间没有显着差异。
结论：移民妇女的BC发病率低于本土妇女，但诊断更多发生在年龄较小并且具有不利的肿瘤特征.参加筛选程序会大大减少后者。因此,建议促进参与筛选计划。
