PO.PS01.04 · 人群科学

移民与文化适应对亚裔美国女性乳腺癌患者死亡率的影响

Impact of immigration and acculturation on mortality in Asian American women with breast cancer

编号 895 展板 8 时间 4/19 02:00–05:00 区域 Section 35 主讲 Alfredo Chua, BSN;MD

分会场 Survivorship Research Addressing Cancer Disparities

查看 PDF 下载 PDF 🔒 查看 / 下载完整 PDF 需登录并开通下载套餐 · 查看套餐 / 开通 AACR 官方页面

作者与单位 Authors & Affiliations

Alfredo V. Chua¹, Rabsa Sikder¹, Luna Gao², Julie Von Behren², Janise M. Roh³, Esperanza Castillo², Isaac J. Ergas³, Iona Cheng², Marilyn L. Kwan³, Salma Shariff-Marco², Mi-Ok Kim², Katherine Lin², Brittany N. Morey⁴, Anna H. Wu⁵, Esther M. John⁶, Lenora W. M. Loo⁷, Allison W. Kurian⁶, Christine B. Ambrosone¹, Lawrence H. Kushi³, Scarlett L. Gomez², Song Yao¹

¹Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY,²Department of Epidemiology & Biostatistics, University of California, San Francisco, CA,³Division of Research, Kaiser Permanente Northern California, Pleasanton, CA,⁴Department of Health, Society & Behavior, Wen School of Population & Public Health, University of California, Irvine, CA,⁵Division of Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, CA,⁶Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA,⁷Department of Epidemiology, University of Hawaiʻi Cancer Center, Honolulu, HI

摘要 Abstract

中文摘要

目的：移民/文化适应可能影响少数种族和民族人群的乳腺癌结局。关于这些因素如何影响亚裔美国乳腺癌女性生存的数据有限。我们研究了移民/文化适应与该人群全因死亡率（ACM）和乳腺癌特异性死亡率（BCSM）的关联。方法：纳入了来自亚裔美国人韧性与癌症差异（ARC）研究的3971名亚裔美国乳腺癌女性。移民/文化适应的测量指标包括出生地（在美国出生 vs. 在美国以外出生）、在美国生活的年数（y）和百分比（%）、移民时的年龄、亚洲出生国以及访谈时的偏好语言。主要结局为ACM和BCSM。采用Cox比例风险模型估计ACM的风险比（HRs），采用Fine和Gray竞争风险模型估计BCSM，并校正临床、人口学、社会经济、生育和生活方式因素。分析按随访时长（≤10 y和>10 y）分层。结果：在美国以外出生的女性在10 y（HR 0.72，95% CI 0.61-0.85，p<0.001）和10 y以上（HR 0.72，95% CI 0.63-0.82，p<0.001）随访时的ACM低于在美国出生的女性。总体上未观察到按出生地划分的BCSM存在统计学显著差异；然而，提示在美国以外出生的女性在随访15 y后BCSM较高。在美国以外出生的女性中，在美国生活时间越长与越高的ACM相关，尤其在40 y和50 y以上（分别为HR 1.49，95% CI 1.05-2.10，p=0.02；HR 1.94，95% CI 1.34-2.81，p<0.001），但校正后不再显著。较早的移民年龄与较低的ACM和BCSM相关，而成年晚期（≥55 y）移民与较高的ACM相关（<10-y HR 2.04，95% CI 1.09-3.80，p=0.02；>10-y HR 2.05，95% CI 1.23-3.41，p=0.006）。然而，校正后，与ACM的关联仅在青少年期（13-17 y）移民（<10-y HR 0.56，95% CI：0.36-0.88，p=0.01）和成年早期（25-34 y）移民（>10-y HR 0.75，95% CI：0.59-0.96，p=0.02）中仍显著。对于BCSM，在青少年期移民（<10-y HR 0.56，95% CI：0.34-0.92，p=0.02）、成年过渡期（18-24 y）移民（>10-y HR 0.71，95% CI：0.52-0.97，p=0.03）和成年中期（35-54 y）移民（<10-y HR 0.62，95% CI：0.39-0.97，p=0.04；>10-y HR 0.60，95% CI：0.40-0.88，p=0.01）中观察到关联。在美国生活的%、亚洲出生国或访谈时偏好语言与ACM或BCSM之间未观察到显著关联。结论：移民因素可能影响亚裔美国乳腺癌女性的长期死亡率。在美国以外出生的女性表现出较低的ACM，但在美国的居留时长和移民年龄可能影响了这一关联。这凸显了需要针对该人群制定文化上量身定制的生存者关怀和公共卫生干预措施，以促进本土文化行为。

查看英文原文 English abstract

Purpose: Immigration/acculturation may affect breast cancer outcomes among minoritized racial and ethnic populations. Limited data exist on how these factors influence survival in Asian American women with breast cancer. We investigated associations of immigration/acculturation with all-cause (ACM) and breast cancer-specific mortality (BCSM) in this population. Methods: 3971 Asian American women with breast cancer were included from the Asian American Resiliency and Cancer Disparities (ARC) Study. Measures of immigration/acculturation included nativity (born in the US vs. outside the US), number of years (y) and percent (%) of life lived in the US, age at immigration, Asian country of birth, and preferred language at interview. Primary outcomes were ACM and BCSM. Cox proportional hazards were used to estimate hazard ratios (HRs) for ACM and Fine and Gray competing risk models for BSCM, adjusted for clinical, demographic, socioeconomic, reproductive, and lifestyle factors. Analyses were stratified by follow-up duration (≤10 y and >10 y). Results: Women born outside the US had lower ACM compared with women born in the US at 10 y (HR 0.72, 95% CI 0.61-0.85, p<0.001) and beyond 10 y (HR 0.72, 95% CI 0.63-0.82, p<0.001) follow-up. No statistically significant differences by nativity in BCSM were observed overall; however, higher BCSM in women born outside the US after 15 y of follow-up was suggested. Among women born outside the US, living longer in the US was associated with higher ACM, particularly beyond 40 and 50 y (HR 1.49, 95% CI 1.05-2.10, p=0.02; HR 1.94, 95% CI 1.34-2.81, p<0.001, respectively), which became non-significant after adjustment. Earlier age at immigration was associated with lower ACM and BCSM, and immigration in late adulthood (≥55 y) with higher ACM (<10-y HR 2.04, 95% CI 1.09-3.80, p=0.02; >10-y HR 2.05, 95% CI 1.23-3.41, p=0.006). However, after adjustment, associations with ACM remained significant only for immigration in adolescence (13-17 y) (<10-y HR 0.56, 95% CI: 0.36-0.88, p=0.01) and early adulthood (25-34 y) (>10-y HR 0.75, 95% CI: 0.59-0.96, p=0.02). For BCSM, associations were seen for immigration in adolescence (<10-y HR 0.56, 95% CI: 0.34-0.92, p=0.02), adult transition (18-24 y) (>10-y HR 0.71, 95% CI: 0.52-0.97, p=0.03) and middle adulthood (35-54 y) (<10-y HR 0.62, 95% CI: 0.39-0.97, p=0.04; >10-y HR 0.60, 95% CI: 0.40-0.88, p=0.01). No significant associations were observed between % of life in the US, Asian country of birth, or preferred language at interview, and ACM or BCSM. Conclusions: Immigration factors may influence long-term mortality in Asian American women with breast cancer. Women born outside the US demonstrated lower ACM, but the length of stay in the US and age at immigration may have influenced this association. This highlights the need for culturally tailored survivorship and public health interventions that promote native cultural behaviors in this population.

利益披露 Disclosure

A. V. Chua, None.. R. Sikder, None.. L. Gao, None.. J. Von Behren, None.. J. M. Roh, None.. E. Castillo, None.. I. J. Ergas, None.. I. Cheng, None.. M. L. Kwan, None.. S. Shariff-Marco, None.. M. Kim, None.. K. Lin, None.. B. N. Morey, None.. A. H. Wu, None.. E. M. John, None.. L. W. Loo, None.. A. W. Kurian, None.. C. B. Ambrosone, None.. L. H. Kushi, None.. S. L. Gomez, None.. S. Yao, None.

← 返回 AACR 2026 检索