Résumé :
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[BDSP. Notice produite par INIST-CNRS 331R0xOQ. Diffusion soumise à autorisation]. Context In recent years a theory that cancer biology is different in blacks and whites has gained prominence in reaction to epidemiologic observations that blacks have poorer survival than whites, even when diagnosed with cancer of similar severity. Yet, few studies have evaluated whether lower-quality treatment and shorter overall life expectancy due to a greater burden of other illnesses may explain the survival discrepancy. Objective To estimate the magnitude of overall and cancer-specific survival differences between blacks and whites who receive comparable treatment for similar-stage cancer. Data Sources We searched MEDLINE for English-language articles published from 1966 to January 2002 that reported on overall survival for black and white patients treated similarly for cancer. Study Selection The abstracts or titles for 891 citations were independently examined by 2 authors. The full text was retrieved if the abstract mentioned both black and white patients, made some comment regarding either similarity of treatment received or presented an analysis based on the treatment received, and commented on survival. Studies were included if they included data for at least 10 black and 10 white patients ; specified the cohort ascertainment method and what measures were undertaken to minimize loss to follow-up ; summarized survival of both blacks and whites using actuarial measures ; presented outcomes within stage, adjusted for stage, or based on cohorts with balanced stage distributions ; and specified that blacks and whites in the study received similar treatment. We identified 89 unique cohorts in 54 articles that met our inclusion criteria. Data Extraction Overall survival rates and hazard ratios (HRs) for death for blacks relative to whites were calculated. (...)
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