目的:这项研究调查了种族对侵袭性子宫内膜癌(EC)诊断的风险,种族,和原籍国进一步阐明非西班牙裔黑人(NHB)的组织学差异,西班牙裔,亚洲/太平洋岛民(API),美洲印第安人/阿拉斯加原住民(AIAN)vs.非西班牙裔白人(NHW)患者,特别是在西班牙裔或API亚组。
方法:患者在2004年至2020年之间诊断为低级别(LG)子宫内膜样子宫内膜癌(ECC)或侵袭性EC,包括3级EEC,浆液性癌,透明细胞癌,混合上皮癌,或癌肉瘤在国家癌症数据库进行了研究。使用逻辑建模估计诊断侵袭性EC组织学的优势比(OR)和95%置信区间(CI)。
结果:有343,868NHW,48,897NHB,30,013西班牙裔,15,015个API和1646个AIAN患者。对于NHB,侵袭性EC诊断的OR(95%CI)为3.07(3.01-3.13),1.08(1.06-1.11)西班牙裔,API为1.17(1.13-1.21),AIAN为1.07(0.96-1.19),相对于NHW患者。按原籍国进行的子集分析说明了西班牙裔美国人中积极的EC诊断的OR多样性(墨西哥为1.18,多米尼加为1.87),亚洲(1.14亚洲印度-巴基斯坦至1.48韩国)和太平洋岛民(夏威夷人1.00至萨摩亚人1.33)的后裔。西班牙裔,API和AIAN患者被诊断为比NHW患者小5岁,校正年龄后,侵袭性EC组织学的风险均显着高于NHW患者。保险状况是侵袭性组织学的另一个独立危险因素。
结论:侵袭性EC诊断的风险因种族而异,种族,和原产国。NHB患者的风险最高,其次是多米尼加,南/中美洲,古巴人,韩语,泰国人,越南人,菲律宾后裔。
This study investigated the risk of an aggressive endometrial cancer (EC) diagnosis by race, ethnicity, and country of origin to further elucidate histologic disparities in non-Hispanic Black (NHB), Hispanic, Asian/Pacific Islander (API), American Indian/Alaskan Native (AIAN) vs. non-Hispanic White (NHW) patients, particularly in Hispanic or API subgroups.
Patient diagnosed between 2004 and 2020 with low grade (LG)-endometrioid endometrial cancer (ECC) or an aggressive EC including grade 3 EEC, serous carcinoma, clear cell carcinoma, mixed epithelial carcinoma, or carcinosarcoma in the National Cancer Database were studied. The odds ratio (OR) and 95% confidence interval (CI) for diagnosis of an aggressive EC histology was estimated using logistic modeling.
There were 343,868 NHW, 48,897 NHB, 30,013 Hispanic, 15,015 API and 1646 AIAN patients. The OR (95% CI) for an aggressive EC diagnosis was 3.07 (3.01-3.13) for NHB, 1.08 (1.06-1.11) for Hispanic, 1.17 (1.13-1.21) for API and 1.07 (0.96-1.19) for AIAN, relative to NHW patients. Subset analyses by country of origin illustrated the diversity in the OR for an aggressive EC diagnosis among Hispanic (1.18 for Mexican to 1.87 for Dominican), Asian (1.14 Asian Indian-Pakistani to 1.48 Korean) and Pacific Islander (1.00 for Hawaiian to 1.33 for Samoan) descendants. Hispanic, API and AIAN patients were diagnosed 5-years younger that NHW patients, and the risk for an aggressive EC histology were all significantly higher than NHW patients after correcting for age. Insurance status was another independent risk factor for aggressive histology.
Risk of an aggressive EC diagnosis varied by race, ethnicity, and country of origin. NHB patients had the highest risk, followed by Dominican, South/Central American, Cuban, Korean, Thai, Vietnamese, and Filipino descendants.