妇科癌症护理方面的种族和民族差异已有记录。在学术机构接受治疗与提高生存率相关，但尚无研究检验妇科癌症患者的种族和民族与机构类型之间的独立关联。我们使用国家癌症数据库并确定了 484,455 名在2004 年和 2020 年。设施类型分为学术型和非学术型，我们使用逻辑回归来估计种族和民族与设施类型之间的多变量调整优势比 (OR) 和 95% 置信区间 (CI)。其次，我们使用 Cox 比例风险回归研究了种族和民族以及设施类型对总体生存率的联合影响。我们观察到美洲印第安人/阿拉斯加原住民在学术（与非学术）设施中接受治疗的几率较高（OR = 1.42, 95 % CI = 1.28-1.57)、亚裔 (OR = 1.64, 95% CI = 1.59-1.70)、黑人 (OR = 1.69, 95% CI = 1.65-1.72)、西班牙裔 (OR = 1.70, 95% CI = 1.66- 1.75）、夏威夷原住民/太平洋岛民（OR = 1.74，95% CI = 1.57-1.93）和其他种族（OR = 1.29，95% CI = 1.20-1.40）患者与白人患者相比。在以白人、学术机构治疗的患者作为参考组的联合效应生存分析中，在学术或非学术机构接受治疗的亚裔、西班牙裔和其他种族患者的总体生存率有所改善。相反，在学术机构 [风险比 (HR) = 1.10，95% CI = 1.07-1.12] 或非学术机构（HR = 1.19，95% CI = 1.16-1.21）接受治疗的黑人患者的生存率较差。 妇科癌症少数化患者比白人患者更有可能在学术机构接受治疗。重要的是，在学术机构接受护理的患者的生存结果因种族而异，需要研究来调查机构内的生存差异。版权所有 © 2024 作者。由爱思唯尔公司出版。保留所有权利。

Racial and ethnic disparities in gynecologic cancer care have been documented. Treatment at academic facilities is associated with improved survival, yet no study has examined independent associations between race and ethnicity with facility type among gynecologic cancer patients.We used the National Cancer Database and identified 484,455 gynecologic cancer (cervix, ovarian, uterine) patients diagnosed between 2004 and 2020. Facility type was dichotomized as academic vs. non-academic, and we used logistic regression to estimate multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) between race and ethnicity and facility type. Secondarily, we examined joint effects of race and ethnicity and facility type on overall survival using Cox proportional hazards regression.We observed higher odds of treatment at academic (vs. non-academic) facilities among American Indian/Alaska Native (OR = 1.42, 95% CI = 1.28-1.57), Asian (OR = 1.64, 95% CI = 1.59-1.70), Black (OR = 1.69, 95% CI = 1.65-1.72), Hispanic (OR = 1.70, 95% CI = 1.66-1.75), Native Hawaiian/Pacific Islander (OR = 1.74, 95% CI = 1.57-1.93), and other race (OR = 1.29, 95% CI = 1.20-1.40) patients compared with White patients. In the joint effects survival analysis with White, academic facility-treated patients as the reference group, Asian, Hispanic, and other race patients treated at academic or non-academic facilities had improved overall survival. Conversely, Black patients treated at academic facilities [Hazard Ratio (HR) = 1.10, 95% CI = 1.07-1.12] or non-academic facilities (HR = 1.19, 95% CI = 1.16-1.21) had worse survival.Minoritized gynecologic cancer patients were more likely than White patients to receive treatment at academic facilities. Importantly, survival outcomes among patients receiving care at academic institutions differed by race, requiring research to investigate intra-facility survival disparities.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.