Racial Differences in Breast Cancer Survival Between Black and White Women According to Tumor Subtype: A Systematic Review and Meta-Analysis.

IF 42.1 1区 医学 Q1 ONCOLOGY Journal of Clinical Oncology Pub Date : 2024-11-10 Epub Date: 2024-09-17 DOI:10.1200/JCO.23.02311
Juliana M Torres, Michelle O Sodipo, Margaret F Hopkins, Paulette D Chandler, Erica T Warner
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Abstract

Purpose: Despite effective early-detection approaches and innovative treatments, Black women in the United States have higher breast cancer mortality rates compared with White women. The purpose of this systematic review and meta-analysis is to determine the extent of disparities in breast cancer survival between Black and White women according to tumor subtype.

Methods: A comprehensive database search was performed for full-text, English-language articles published from January 1, 2000, to December 31, 2022. Included studies compared survival between Black and White female patients with breast cancer within subtypes defined by hormone receptor and human epidermal growth factor receptor 2 (HER2)/neu (HER2; now known as ERBB2) status. Random-effects models were used to combine study-specific results and generate pooled relative risks (RRs) and 95% CIs for breast cancer-specific or overall survival (OS). A protocol for this review was registered in PROSPERO (CRD42021268212).

Results: Eighteen studies including 228,885 (34,262 Black; 182,466 White) patients with breast cancer were identified. Compared with White women, Black women had a higher risk of breast cancer death for all tumor subtypes. The summary risk of breast cancer death was 50% higher among hormone receptor-positive HER2-negative [HER2-] tumors (RR, 1.50 [95% CI, 1.30 to 1.72]), 34% higher for hormone receptor+/HER2+ (RR, 1.34 [95% CI, 1.10 to 1.64]), 20% higher for hormone receptor-negative (-)/HER2+ (RR, 1.29 [95% CI, 1.00 to 1.43]), and 17% higher among individuals with hormone receptor-/HER2- tumors (hazard ratio, 1.17; 95% CI, 1.10 to 1.25). Black women also had poorer OS than White women for all subtypes.

Conclusion: These results suggest there are both subtype-specific and subtype-independent mechanisms that contribute to disparities in breast cancer survival between Black and White women, which require multilevel interventions to address and achieve health equity.

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肿瘤亚型对黑人和白人女性乳腺癌生存率的种族差异:系统回顾与元分析》。
目的:尽管采用了有效的早期检测方法和创新的治疗方法,美国黑人妇女的乳腺癌死亡率仍高于白人妇女。本系统综述和荟萃分析的目的是根据肿瘤亚型确定黑人和白人女性乳腺癌生存率的差异程度:方法:对 2000 年 1 月 1 日至 2022 年 12 月 31 日期间发表的全文英文文章进行了全面的数据库检索。所纳入的研究比较了根据激素受体和人类表皮生长因子受体 2 (HER2)/neu (HER2; 现称为 ERBB2) 状态定义的亚型中黑人和白人女性乳腺癌患者的生存率。随机效应模型用于合并研究的特异性结果,并生成乳腺癌特异性或总生存期(OS)的汇总相对风险系数(RRs)和 95% CIs。本综述的方案已在 PROSPERO(CRD42021268212)上注册:结果:共确定了 18 项研究,包括 228,885 名(34,262 名黑人;182,466 名白人)乳腺癌患者。与白人女性相比,黑人女性在所有肿瘤亚型中的乳腺癌死亡风险都更高。激素受体阳性 HER2 阴性 [HER2-] 肿瘤的乳腺癌死亡风险总和高出 50%(RR,1.50 [95% CI,1.30 至 1.72]),激素受体+/HER2+肿瘤的死亡风险高出 34%(RR,1.34 [95% CI,1.10至1.64])高出34%,激素受体阴性(-)/HER2+高出20%(RR,1.29 [95% CI,1.00至1.43]),激素受体-/HER2-肿瘤患者高出17%(危险比,1.17;95% CI,1.10至1.25)。在所有亚型中,黑人女性的OS也比白人女性差:这些结果表明,造成黑人和白人女性乳腺癌生存率差异的既有亚型特异性机制,也有亚型非特异性机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Clinical Oncology
Journal of Clinical Oncology 医学-肿瘤学
CiteScore
41.20
自引率
2.20%
发文量
8215
审稿时长
2 months
期刊介绍: The Journal of Clinical Oncology serves its readers as the single most credible, authoritative resource for disseminating significant clinical oncology research. In print and in electronic format, JCO strives to publish the highest quality articles dedicated to clinical research. Original Reports remain the focus of JCO, but this scientific communication is enhanced by appropriately selected Editorials, Commentaries, Reviews, and other work that relate to the care of patients with cancer.
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