Higher disease burden and lower utilization in mongolian with breast cancer: a 9-year retrospective cohort study of 18.19 million adults in China

Author:

Chen Jieying1,Qiao Liying2,Qi Meng3,Zhang Yunjing4,Yan Ying5,Kang Weiwei2,Zhou Huziwei4,Yu Yuelin4,Ke Yalei4,Jiang Yuling4,Rao Yingting4,Xu Lu6,He Guohua7,Ren Jing2,Yan Xue2,Deng Siwei4,Yang Xinyu8,Song Yutong8,Yang Yingzi4,Wen Qiaorui4,Han Jing2,Wu Yiwei2,Liu Guozhen9,Wang Mingyuan9,Zhang Xiaoyu8,Xi Yunfeng2,Wang Shengfeng4

Affiliation:

1. School of Health Humanities, Peking University, Beijing, China

2. Inner Mongolia Integrative Center for Disease Control and Prevention, Hohhot, China

3. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Breast Center, Peking University Cancer Hospital & Institute, Beijing, China

4. Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China

5. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Breast Oncology, Peking University Cancer Hospital & Institute, Beijing, China

6. Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China

7. The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

8. School of Public Health, Peking University, Beijing, China

9. Peking University Health Information Technology, Beijing, China

Abstract

Background: Whether health inequalities of disease burden and medical utilization exist by ethnicity in Asian breast cancer (BC) patients remains unclear. We aim to measure ethnic disparities in disease burden and utilization among Mongolian and Han female breast cancer patients in China. Materials and Methods: Based on data extracted from Inner Mongolia Regional Health Information Platform, a retrospective cohort study was established during 2012-2021. Disease burden including incidence, 5-year prevalence, mortality, survival rate, and medical cost were analyzed and compared between Han and Mongolian patients. Results: A total of 34,878 female patients (mean [SD] age, 52.34 [10.93] years) were included among 18.19 million Chinese, and 4,315 [12.03%] participants were Mongolian. Age-standardized rates of incidence are 32.68 (95% CI: 20.39-44.98) per 100,000. Higher age-specific incidence and 5-year prevalence were observed in Mongolian than in Han. The cost of breast cancer annually per capita was significantly lower for Mongolian than Han in FBC ($1,948.43 [590.11-4 776.42] vs. $2,227.35 [686.65-5,929.59], P<0.001). Mongolian females showed higher all-cause mortality (30.92, [95% CI: 28.15-33.89] vs. 27.78, [95% CI: 26.77-28.83] per 1,000, P=0.036) and breast cancer-specific mortality (18.78, [95% CI: 16.64-21.13] vs. 15.22, [95% CI: 14.47-16.00] per 1,000, P=0.002) than Han females. After adjusting covariates, Mongolian were associated with increased all-cause mortality (HR, 1.21, [95% CI, 1.09-1.34]; P<0.001) and breast cancer-specific mortality (HR, 1.31, [95% CI, 1.14-1.49]; P<0.001) Conclusion: The findings of this cohort study highlight a higher level of disease burden with unmet medical demand in Mongolian patients, suggesting that more practical efforts should be made for the minority. Further research is needed to explore the concrete mechanisms of the disparities as well as eliminate health disproportion.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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