PO.PS01.02 · 人群科学

Florida州和美国男性乳腺癌结局按种族/族裔的差异：FCDS与SEER的基于人群的比较

Differences in male breast cancer outcomes by race/ethnicity in Florida and the United States: A population-based comparison of FCDS and SEER

编号 3568 展板 18 时间 4/20 02:00–05:00 区域 Section 34 主讲 Maurice Chery, MD

分会场 Cancer Surveillance: Emerging Cancer Trends and Population Differences

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作者与单位 Authors & Affiliations

Maurice Chery¹, Alex Sanchez¹, Jovanka Ravix¹, Olusanya Joshua Oluwole¹, Priscila Barreto Coelho¹, Kristy Samaroo¹, Fatima Rasheed¹, Ayodele Omotoso¹, Osmaray Morales Casanova¹, Matthew Schlumbrecht², Sophia Hl George³

¹University of Miami, Miller School of Medicine, Miami, FL,²Division of Gynecology Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami, Miller School of Medicine, Miami, FL,³Univ. of Miami Sylvester Comprehensive Cancer Ctr., Miami, FL

摘要 Abstract

中文摘要

引言：男性乳腺癌（MBC）罕见（<1%的美国病例）但具有重要临床意义。关于种族/族裔差异的证据有限，且往往来自单一登记处。我们表征MBC的社会人口学、临床和治疗特征，并评估Florida州和更广泛的美国与种族/族裔和出生地相关的总生存（OS）关联因素。方法：我们对Florida癌症数据系统（FCDS，1981-2020；N=1,878）和SEER 8登记处（1975-2022；N=4,754）进行了回顾性队列研究，纳入原发性MBC（ICD-O-C56XX）。我们描述了社会人口学变量（年龄、种族/族裔；FCDS另加保险/吸烟；SEER另加婚姻状态/地区水平收入）、临床特征（分级、分期、ER/PR/HER2）和治疗类型（手术、化疗、放疗）。各登记处特异的Cox模型共用相同的校正集（年龄、分级、分期、ER/PR/HER2、手术、化疗、放疗）。种族/族裔分为非西班牙裔白人（NHW）、非西班牙裔黑人（NHB）和西班牙裔（Hispanic）。在FCDS中，我们还检验了出生地（在美国出生 vs 非美国出生）的调节效应以及种族与出生地的联合效应。结果：在FCDS中（n=1,878；80% NHW，12% NHB，8% Hispanic；平均年龄67.5岁），NHB男性与NHW和Hispanic相比诊断时更年轻（61 vs 69 vs 67岁），OS更短（38 vs 59 vs 49个月），高级别肿瘤更多（56% vs 37% vs 38%），远处分期更多（15% vs 7% vs 11%），手术率更低（77% vs 90% vs 86%；均p<0.01）；ER/PR/HER2状态在各种族/族裔间无差异。在SEER中（n=4,754；84% NHW，11% NHB，5% Hispanic；平均年龄67.0岁），NHB男性更年轻（62 vs 68 vs 64岁），OS更短（54 vs 70 vs 63个月），远处分期更多（14% vs 7% vs 11%），手术率更低（84% vs 91% vs 89%；均p<0.01）。NHB男性的ER阳性肿瘤（92% vs 96% vs 94%）和PR阳性肿瘤（80% vs 89% vs 85%；p<0.01）更少，而HER2状态在各种族/族裔间无差异。在多变量模型中，种族/族裔在FCDS中与OS无关联；然而在NHB男性中，非美国出生者的死亡率低于美国出生者（HR 0.54；95% CI 0.34-0.86；交互作用p=0.01）。在SEER中，NHB男性的死亡率高于NHW（HR 1.22；95% CI 1.07-1.38）。在两个登记处中，较大年龄、高级别、远处分期和未行手术均独立地与较高死亡率相关（均p<0.01）。结论：在Florida州和整个美国，MBC的OS主要由年龄、分级、分期和手术决定。在SEER中，NHB的校正死亡率高于NHW，这一效应在FCDS中未见。在FCDS中，出生地调节黑人男性的风险：非美国出生者的死亡率低于美国出生者。这些发现支持按出生地分层的监测以及促进更早诊断和一致获得根治性手术的公平性努力。

查看英文原文 English abstract

Introduction Male breast cancer (MBC) is rare (<1% of U.S. cases) yet clinically important. Evidence on racial/ethnic differences is limited and often comes from single registries. We characterize sociodemographic, clinical, and treatment features of MBC and evaluate factors associated with overall survival (OS) in Florida and the broader United States in relation to race/ethnicity and nativity. Methods We performed a retrospective cohort study of the Florida Cancer Data System (FCDS, 1981-2020; N=1,878) and SEER 8 registries (1975-2022; N=4,754), including primary MBC (ICD-O-C56XX). We described sociodemographic variables (age, race/ethnicity; plus insurance/smoking in FCDS; marital status/area-level income in SEER), clinical features (grade, stage, ER/PR/HER2), and treatment types (surgery, chemotherapy, radiation). Registry-specific Cox models shared the same adjustment set (age, grade, stage, ER/PR/HER2, surgery, chemotherapy, radiation). Race/ethnicity was categorized as non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic. In FCDS, we also tested the moderating effect of nativity (U.S.-born vs non-U.S.-born) and the joint effect of race and nativity. Results In FCDS (n=1,878; 80% NHW, 12% NHB, 8% Hispanic; mean age 67.5 years), NHB men vs NHW and Hispanic were younger at diagnosis (61 vs 69 vs 67 years), had shorter OS (38 vs 59 vs 49 months), more high-grade tumors (56% vs 37% vs 38%), more distant stage (15% vs 7% vs 11%), and lower surgery rates (77% vs 90% vs 86%; all p<0.01); ER/PR/HER2 status did not differ by race/ethnicity. In SEER (n=4,754; 84% NHW, 11% NHB, 5% Hispanic; mean age 67.0 years), NHB men were younger (62 vs 68 vs 64 years), had shorter OS (54 vs 70 vs 63 months), more distant stage (14% vs 7% vs 11%), and lower surgery rates (84% vs 91% vs 89%; all p<0.01). NHB men had fewer ER-positive (92% vs 96% vs 94%) and PR-positive tumors (80% vs 89% vs 85%; p<0.01), while HER2 status did not vary by race/ethnicity. In multivariable models, race/ethnicity was not associated with OS in FCDS; however, among NHB men, non-U.S.-born had lower mortality than U.S.-born (HR 0.54; 95% CI 0.34-0.86; interaction p=0.01). In SEER, NHB men had higher mortality than NHW (HR 1.22; 95% CI 1.07-1.38). In both registries, older age, high grade, distant stage, and omission of surgery were independently associated with higher mortality (all p<0.01). Conclusion Across Florida and the United States, MBC OS is chiefly determined by age, grade, stage, and surgery. In SEER, NHB have higher adjusted mortality than NHW, an effect not seen in FCDS. In FCDS, nativity modifies risk among Black men: non-USB have lower mortality than USB. These findings support nativity-stratified surveillance and equity efforts to promote earlier diagnosis and consistent access to definitive surgery.

利益披露 Disclosure

M. Chery, None.. A. Sanchez, None.. J. Ravix, None.. O. J. Oluwole, None.. P. Barreto Coelho, None.. K. Samaroo, None.. F. Rasheed, None.. A. Omotoso, None.. O. Morales Casanova, None.. M. Schlumbrecht, None.

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