Breast cancer-specific survival among immigrants and non-immigrants invited to BreastScreen Norway

IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Sameer Bhargava , Jonas Gjesvik , Jonas Thy , Marthe Larsen , Solveig Hofvind
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引用次数: 0

Abstract

Introduction

We have previously shown that immigrants have lower attendance in BreastScreen Norway than non-immigrants and that non-Western immigrants have lower incidence of breast cancer, but more advanced disease.

Purpose

To compare breast cancer-specific survival for immigrants versus non-immigrants diagnosed with screen-detected or symptomatic breast cancer.

Material and methods

We analyzed data from 28,320 women aged 50–69 diagnosed with breast cancer after being invited to BreastScreen Norway. We divided women into three groups; non-immigrants, immigrants from Western countries and immigrants from non-Western countries. We stratified our analyses according to detection mode (screen-detected breast cancer, interval cancer and cancer detected outside screening), and used cox regression to model the association between immigrants/non-immigrants and time to breast cancer death.

Results

Among screen-detected breast cancers, 28.7% were histologic grade 3 among immigrants from non-Western countries compared to 21.3% among non-immigrants. Interval cancers and cancers detected outside screening had larger tumor diameter and a higher percentage were histologic grade 3 and lymph node positive among immigrants from non-Western countries compared to non-immigrants. Hazard ratio (95% confidence interval) adjusted for age and year of diagnosis for time to breast cancer death compared to non-immigrants was 0.70 (0.39–1.27) for immigrants from Western countries and 0.52 (0.23–1.17) for immigrants from non-Western countries.

Conclusion

Despite more advanced histopathological tumor characteristics among immigrants from non-Western countries compared to non-immigrants, we did not observe statistically significant differences in breast-cancer specific survival between the two groups. Keeping in mind the low number of breast cancer deaths and possible overestimation of survival among immigrants, this might imply that equity in outcome can be achieved through adequate follow-up and treatment despite inequal access.

应邀参加挪威乳腺癌筛查的移民和非移民的乳腺癌特异性存活率
导言我们以前的研究表明,移民参加挪威乳腺癌筛查的人数低于非移民,非西方移民的乳腺癌发病率较低,但晚期乳腺癌发病率较高。我们将妇女分为三组:非移民、来自西方国家的移民和来自非西方国家的移民。我们根据检测模式(筛查发现的乳腺癌、间隔期癌症和筛查外发现的癌症)进行了分层分析,并使用cox回归法建立了移民/非移民与乳腺癌死亡时间之间的关系模型。结果在筛查发现的乳腺癌中,非西方国家移民中28.7%的乳腺癌属于组织学3级,而非移民中这一比例为21.3%。与非移民相比,来自非西方国家的移民中间隔期癌症和筛查外发现的癌症的肿瘤直径更大,组织学分级为3级和淋巴结阳性的比例更高。经年龄和诊断年份调整后,与非移民相比,西方国家移民乳腺癌死亡时间的危险比(95% 置信区间)为 0.70(0.39-1.27),非西方国家移民为 0.52(0.23-1.17)。考虑到乳腺癌死亡人数较少以及移民的存活率可能被高估,这可能意味着,尽管机会不平等,但通过适当的随访和治疗可以实现结果公平。
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 Migration and Health
Journal of Migration and Health Social Sciences-Sociology and Political Science
CiteScore
5.70
自引率
8.70%
发文量
65
审稿时长
153 days
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