Impact of Immigration Status on Survival Among Stage 1 and 2 HER2-Positive and Triple-Negative Breast Cancer in Ontario, Canada

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2025-09-30 DOI:10.1002/cam4.71288

Omolara Fatiregun, Rinku Sutradhar, Sho Podolsky, Andrea Eisen, Lawrence Paszat, Eileen Rakovitch

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Abstract

Background

This study examined death from breast cancer and death from other causes among women with Stage 1 and 2 Her2-positive and triple-negative breast cancer (BC) by immigration status.

Methods

We identified women aged 18–75 diagnosed with BC in Ontario from January 1, 2012, to December 31, 2019, followed them to December 31, 2023, and identified legal immigrants from the Immigration, Refugee, and Citizenship Canada Permanent Resident (CIC) database. We linked administrative data sources for the date of diagnosis, molecular subtype, death due to breast cancer, and death due to all other causes. Using adjusted competing risks regression (Fine and Gray method), we analyzed the influence of immigration on breast cancer survival and calculated the sub-distribution hazard ratios (sHR).

Results

There was no increased risk of death among legal immigrants on univariate or multivariable analysis. They had a sHR of 0.95 (0.77–1.19) on univariate analysis and 1.06 (95% CI: 0.83–1.36) on multivariable analysis for breast cancer deaths, and for other causes of death, 0.63 (0.47–0.83) on univariate analysis, and 0.85 (95% CI: 0.62–1.15) on multivariable analysis compared to long-term residents. Patients with HER2-positive status had a lower risk of death from breast cancer and other causes compared to those with triple-negative breast cancer (TNBC). Patients with Stage 2 cancer had a significantly higher hazard of death from breast cancer compared to Stage 1 (HR = 3.72, 95% CI: 2.96–4.66, p < 0.0001).

Conclusions

In Ontario, legal immigrants do not have an increased risk of death from breast cancer or other causes compared to long-term residents.

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加拿大安大略省移民身份对1期和2期her2阳性和三阴性乳腺癌患者生存的影响

背景：本研究通过移民身份调查了1期和2期her2阳性和三阴性乳腺癌（BC）妇女因乳腺癌和其他原因死亡的情况。方法：选取2012年1月1日至2019年12月31日在安大略省诊断为BC的18-75岁女性，随访至2023年12月31日，并从加拿大移民、难民和公民身份永久居民（CIC）数据库中确定合法移民。我们将诊断日期、分子亚型、乳腺癌死亡和所有其他原因导致的死亡的行政数据源联系起来。采用调整竞争风险回归（Fine and Gray法）分析移民对乳腺癌生存的影响，并计算亚分布风险比（sHR）。结果：在单因素和多因素分析中，合法移民的死亡风险没有增加。与长期居民相比，乳腺癌死亡和其他死因的单变量分析的sHR为0.95(0.77-1.19)，多变量分析的sHR为1.06 (95% CI: 0.83-1.36)，单变量分析的sHR为0.63(0.47-0.83)，多变量分析的sHR为0.85 （95% CI: 0.62-1.15）。与三阴性乳腺癌（TNBC）患者相比，her2阳性患者死于乳腺癌和其他原因的风险较低。与1期相比，2期癌症患者死于乳腺癌的风险明显更高（HR = 3.72, 95% CI: 2.96-4.66, p）。结论：在安大略省，与长期居民相比，合法移民死于乳腺癌或其他原因的风险没有增加。

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

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.