旨在调查种族居住隔离对黑人和白人患者在诊断、接受手术和生存阶段的差异的影响。受试者包括从监测、流行病学和最终结果中获得的 2005 年至 2015 年间诊断为卵巢癌的黑人和白人患者。结果计划。人口统计数据来自 2010 年十年一次的人口普查和 2013 年美国社区调查。感兴趣的暴露是相异指数（IOD），这是一种经过验证的隔离衡量标准。感兴趣的结果包括局部疾病诊断和手术时晚期的相对风险、5 年总体生存率和癌症特异性生存率。与白人相比，黑人女性更容易患 IV 期卵巢癌（32% vs 25%） ，p < 0.001），总体上较少接受手术切除（64% vs 75%，p < 0.001）。对于黑人患者，IOD 增加与晚期就诊风险增加 25% 相关（RR 1.25，95% CI 1.08，1.45），而对于白人患者，IOD 则降低 15%（RR 0.85，95% CI 0.73，0.99）。 IOD 增加与黑人患者接受手术切除的可能性降低 18% 相关（RR 0.82，95% CI 0.77，0.87），但与白人患者没有显着相关性（RR 1.01，95% CI 0.96，1.08）。与处于最低隔离水平的白人患者相比，处于最高隔离水平的黑人患者的死亡亚危险高出 17%（HR 1.17，95% CI 1.07，1.27），而处于最低隔离水平的黑人患者的亚危险性高出 17%（HR 1.17，95% CI 1.07，1.27）。无显着差异（HR 1.13，95% CI 0.99，1.29）。我们的研究结果证明了历史上政府强制隔离对患有卵巢癌的黑人女性的直接危害。版权所有 © 2024 Elsevier Inc. 保留所有权利。

To investigate the effect of racial residential segregation on disparities between Black and White patients in stage at diagnosis, receipt of surgery, and survival.Subjects included Black and White patients diagnosed with ovarian cancer between 2005 and 2015 obtained from the Surveillance, Epidemiology, and End Results Program. Demographic data were obtained from the 2010 decennial census and 2013 American Community Survey. The exposure of interest was the index of dissimilarity (IOD), a validated measure of segregation. The outcomes of interest included relative risk of advanced stage at diagnosis and surgery for localized disease, 5-year overall and cancer-specific survival.Black women were more likely to present with Stage IV ovarian cancer when compared to White (32% vs 25%, p < 0.001) and less often underwent surgical resection overall (64% vs 75%, p < 0.001). Increasing IOD was associated with a 25% increased risk of presenting at advanced stage for Black patients (RR 1.25, 95% CI 1.08, 1.45), and a 15% decrease for White patients (RR 0.85, 95% CI 0.73, 0.99). Increasing IOD was associated with an 18% decreased likelihood of undergoing surgical resection for black patients (RR 0.82, 95% CI 0.77, 0.87), but had no significant association for White patients (RR 1.01, 95% CI 0.96, 1.08). When compared to White patients in the lowest level of segregation, Black patients in the highest level of segregation had a 17% higher subhazard of death (HR 1.17, 95% CI 1.07, 1.27), while Black patients in the lowest level of segregation had no significant difference (HR 1.13, 95% CI 0.99, 1.29).Our findings demonstrate the direct harm of historical government mandated segregation on Black women with ovarian cancer.Copyright © 2024 Elsevier Inc. All rights reserved.