Firestone Ridvan Tupai, Ellison-Loschmann Lis, Shelling Andrew N, Ekeroma Alec, Ikenasio-Thorpe Bettina A, Pearce Neil, Jeffreys Mona
Centre for Public Health Research, Massey University, Wellington, New Zealand.
J Fam Plann Reprod Health Care. 2012 Oct;38(4):239-45. doi: 10.1136/jfprhc-2011-100113. Epub 2012 Jan 12.
Little is known about the ethnic differences in disease presentation of uterine cancer in New Zealand women. The objectives of this study were two-fold: (1) to estimate the incidence and mortality of uterine cancer among women in New Zealand and (2) to examine the association of ethnicity and socioeconomic status with tumour stage and grade, at presentation of uterine cancer.
Retrospective survey of cancer cases identified from the New Zealand Cancer Registry. The authors analysed all 3203 uterine cancer cases registered with the New Zealand Cancer Registry during the period 1 January 1997 to 31 December 2006. Ethnic groups were defined based on the self-identified ethnicity recorded on the cancer registry: Ma-ori, Pacific and non-Māori non-Pacific women. Socioeconomic status was categorised as quintiles of the New Zealand Deprivation Index 2006. The mortality to incidence ratio was used as a measure of prognosis. Logistic regression was used to estimate age, ethnic and deprivation adjusted odds ratios (ORs) and 95% confidence intervals (CIs).
Pacific and Māori women have higher incidence (32.4 and 17.7 per 100 000 women, respectively) and mortality rates of uterine cancer (12.1 and 7.4 per 100 000 women, respectively). Women in the most deprived areas are more likely to present with an advanced stage of uterine cancer (OR 1.64, 95% CI 1.09-2.48). Māori and Pacific women are less likely to present with well-differentiated tumours (OR 0.69, 95% CI 0.52-0.92 and OR 0.72, 95% CI 0.52-0.99, respectively).
Māori and Pacific women, and those from lower socioeconomic areas, are more likely to present with advanced uterine cancer.
对于新西兰女性子宫癌疾病表现的种族差异了解甚少。本研究的目的有两个:(1)估计新西兰女性子宫癌的发病率和死亡率;(2)在子宫癌确诊时,研究种族和社会经济地位与肿瘤分期及分级之间的关联。
对从新西兰癌症登记处识别出的癌症病例进行回顾性调查。作者分析了1997年1月1日至2006年12月31日期间在新西兰癌症登记处登记的所有3203例子宫癌病例。种族群体根据癌症登记处记录的自我认定种族来定义:毛利人、太平洋岛民以及非毛利非太平洋岛民女性。社会经济地位被分类为2006年新西兰贫困指数的五分位数。死亡率与发病率之比用作预后指标。采用逻辑回归来估计年龄、种族和贫困调整后的优势比(OR)及95%置信区间(CI)。
太平洋岛民和毛利女性子宫癌的发病率(分别为每10万名女性32.4例和17.7例)和死亡率(分别为每10万名女性12.1例和7.4例)更高。最贫困地区的女性更有可能出现子宫癌晚期(OR 1.64,95% CI 1.09 - 2.48)。毛利和太平洋岛民女性出现高分化肿瘤的可能性较小(分别为OR 0.69,95% CI 0.52 - 0.92和OR 0.72,95% CI 0.52 - 0.99)。
毛利和太平洋岛民女性以及来自社会经济地位较低地区的女性更有可能出现晚期子宫癌。