背景:关于乳腺癌(BC)诊断后的社会支持和其他社会健康决定因素及其与死亡率的关系的研究很少;结果尚无定论。Further,目前尚不清楚观察到的关联是否特定于有BC诊断的女性,或者健康女性之间的关联是否相似.
方法:发生事故的妇女,经病理证实的侵袭性BC,I-IV期(n=1012)和健康频率年龄匹配的对照(n=2036),在一项基于人群的病例对照研究的前瞻性随访中回答了社会支持问卷,纽约西部暴露和乳腺癌(WEB)研究。面试时,所有参与者年龄为35~79岁,居住在纽约州西部的两个县.死亡率状况是根据国家死亡指数确定的。参与者被询问他们的亲密朋友的数量,看到它们的频率,家庭大小,家庭收入,和婚姻状况。估计了BC特异性死亡率(仅限BC女性)和全因死亡率的危险比(HR)和95%置信区间(CI)。
结果:在诊断为BC的女性中,较低的家庭收入与较高的全因死亡率相关(HR2.48,95%CI,1.24-4.97),在健康女性中也是如此(HR2.63,95%CI,1.25-5.53)。见朋友的次数和频率,婚姻状况,家庭规模与死亡率无关,在BC患者或健康女性中。
结论:在被诊断为BC和健康女性中,较低的收入与两倍以上的死亡率相关.婚姻状况,家庭大小,与朋友见面的次数或频率与生存无关.
BACKGROUND: There are few studies of social support and other social determinants of health after breast cancer diagnosis and their associations with mortality; results have been inconclusive. Further, it is not known if observed associations are specific to women with breast cancer diagnosis or if associations would be similar among healthy women.
METHODS: Women with incident, pathologically confirmed invasive breast cancer, stage I-IV (n = 1012), and healthy frequency age-matched participants (n = 2036) answered a social support questionnaire in prospective follow-up of a population-based case-control study, the Western New York Exposures and Breast Cancer Study. At interview, all participants were aged 35-79 years and resident of 2 counties in Western New York State. Mortality status was ascertained from the National Death Index. Participants were queried regarding the number of their close
friends, frequency of seeing them, household size, household income, and marital status. Hazard ratios (HRs) and 95% confidence intervals (CIs) for breast cancer-specific mortality (breast cancer women only) and all-cause mortality were estimated.
RESULTS: Lower household income was associated with higher all-cause mortality among women diagnosed with breast cancer (HR = 2.48, 95% CI = 1.24 to 4.97) and similarly among the healthy women (HR = 2.63, 95% CI = 1.25 to 5.53). Number and frequency of seeing
friends, marital status, and household size were not associated with mortality, either among breast cancer patients or among healthy women.
CONCLUSIONS: Among those diagnosed with breast cancer and healthy women, lower income was associated with more than twice the mortality. Marital status, household size, and number or frequency of meeting
friends were not associated with survival.