PURPOSE:We investigated comorbidities and endometrial cancer survival by ethnicity because Hispanic whites (HWs) have worse survival than non-Hispanic whites (NHWs). METHODS:An endometrial cancer cohort (1992-2004) established with the Surveillance, Epidemiology and End Results-Medicare-linked database (n = 3,286) was followed through 2007. Endometrial cancer-specific and other cause mortality were evaluated with multivariate hazard ratios (mHRs). RESULTS:HWs were more likely than NHWs to have regional/distant disease (31.7 vs. 24.8 %), diabetes (31.7 vs. 11.0 %), and hypertension (49.4 vs. 37.6 %). HWs had poorer endometrial cancer-specific survival than NHWs (age-adjusted HR = 1.28; 95% CI 1.01-1.61), but not after adjustment for tumor characteristics and treatment (mHR = 1.02; 95% CI 0.81-1.29). In contrast, even after adjustment for cancer-related factors, other cause mortality in HWs was elevated (mHR = 1.27; 95% CI 1.01-1.59), but not after further adjustment for comorbid conditions (mHR = 1.07; 95% CI 0.85-1.35). CONCLUSIONS:Comorbidities, particularly diabetes, were more common in HWs than in NHWs and impacted other cause mortality. Improving diabetes management may be an effective means of improving other cause mortality. This may be particularly true for HWs, given their particularly high prevalence of diabetes.

译文

目的:我们按种族调查了合并症和子宫内膜癌的存活率,因为西班牙裔白人(HWs)的生存率较非西班牙裔白人(NHWs)差。
方法:通过监测,流行病学和最终结果-医疗保险相关数据库(n = 3,286)建立的子宫内膜癌队列(1992-2004)一直持续到2007年。 mHRs)。
结果:HWs比NHWs更容易发生区域性/远距离疾病(31.7 vs. 24.8%),糖尿病(31.7 vs. 11.0%)和高血压(49.4 vs. 37.6%)。硬体患者的子宫内膜癌特异性生存率较NHW差(年龄调整后的HR = 1.28; 95%CI 1.01-1.61),但在调整肿瘤特征和治疗后未见异常(mHR = 1.02; 95%CI 0.81-1.29)。相比之下,即使在调整了癌症相关因素后,硬件中的其他原因死亡率也有所提高(mHR = 1.27; 95%CI 1.01-1.59),但在对合并症进行了进一步调整后并未升高(mHR = 1.07; 95%CI 0.85- 1.35)。
结论:合并症,尤其是糖尿病,在家庭医院中比在家庭医院中更为常见,并且会影响其他原因的死亡率。改善糖尿病管理可能是改善其他原因死亡率的有效手段。考虑到HW的糖尿病患病率特别高,这可能尤其如此。

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