Cancer health disparities and risk factors: lessons from a woman with a 20-cm chest wall mass, growing for 2 years

Janghee Woo, N. Palmisiano, G. Váradi
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Abstract

The National Cancer Institute (NCI) has defined cancer health disparities as adverse differences in incidence, prevalence, mortality, survivorship, and burden of cancer or related health conditions that exist among specific populations in the United States. African Americans are more likely than members of any other racial or ethnic population to develop and die from cancer. African American women are more likely than are white women to die of breast cancer, although African American women have a lower incidence rate of this disease than white women. The most conspicuous factors that contribute to the observed disparities are associated with a lack of health care coverage, low socioeconomic status, and race/ethnicity. We recently provided care to a woman who presented to the emergency room with 20-cm chest wall mass. She was found to have inoperable stage IV triple-negative breast cancer with significantly poor prognosis. We describe her presentation, diagnosis, and treatment, identify the factors that contributed to her current condition, discuss the cancer health disparities and the associated risk factors, and reiterate what physicians should know to prevent similar unfortunate and unnecessary scenarios.
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癌症健康差异和危险因素:来自一名胸壁肿块20厘米,生长2年的妇女的经验教训
美国国家癌症研究所(NCI)将癌症健康差异定义为在美国特定人群中存在的癌症发病率、流行率、死亡率、存活率和癌症负担或相关健康状况的不利差异。非裔美国人比其他种族或民族的人更容易患癌症并死于癌症。非裔美国妇女比白人妇女更有可能死于乳腺癌,尽管非裔美国妇女的发病率低于白人妇女。造成所观察到的差异的最明显因素与缺乏医疗保健覆盖、低社会经济地位和种族/族裔有关。我们最近收治了一位因胸壁20厘米肿块而到急诊室就诊的妇女。她被发现患有无法手术的IV期三阴性乳腺癌,预后明显较差。我们描述了她的表现、诊断和治疗,确定了导致她目前状况的因素,讨论了癌症健康差异和相关的风险因素,并重申了医生应该知道的,以防止类似的不幸和不必要的情况。
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