Despite numerous studies documenting ethnic inequalities in breast cancer survival between minority and majority ethnic groups worldwide, reasons for these inequalities remain unclear. The authors performed a systematic review of published literature to identify studies that investigated the explanatory power of smoking, alcohol consumption, body mass index (BMI), and socioeconomic position (SEP) on ethnic inequalities in breast cancer survival. Sixteen studies were included in the review. From 5 studies, the authors found that differences in breast cancer survival between ethnic groups may be in part explained by BMI, but there was little evidence to implicate smoking or alcohol consumption as explanatory factors of this inequality. From 12 studies, the authors found that SEP explains part of the ethnic inequality in all-cause survival but that it was not evident for breast-cancer-specific survival. SEP explains more of the disparities among African-American versus white women in the United States compared with other ethnic comparisons. Furthermore, given social patterning of BMI and other lifestyle habits, it is possible that results for SEP and BMI are measuring the same effect. In this review, the authors make suggestions regarding the role of epidemiology in facilitating further research to better inform the development of effective policies to address ethnic differences in survival.

中文翻译：

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生活方式或社会因素是否解释了乳腺癌生存中的种族/种族不平等？

尽管有大量的研究记录了全世界少数族裔和多数族裔之间在乳腺癌生存中的种族不平等，但这些不平等的原因仍不清楚。作者对发表的文献进行了系统的回顾，以鉴定研究对吸烟中种族不平等的吸烟，饮酒，体重指数（BMI）和社会经济地位（SEP）的解释力。该评价包括十六项研究。从5项研究中，作者发现，不同种族之间乳腺癌生存率的差异可能部分由BMI来解释，但几乎没有证据表明吸烟或饮酒是造成这种不平等的原因。根据12项研究，这组作者发现，SEP可以解释全因生存中的部分种族不平等现象，但对于乳腺癌特异性的生存却并不明显。与其他种族比较相比，SEP解释了美国非裔美国人与白人妇女之间的更多差异。此外，考虑到BMI和其他生活方式习惯的社交模式，SEP和BMI的结果可能正在衡量相同的效果。在这篇综述中，作者对流行病学在促进进一步研究中的作用提出了建议，以更好地指导制定有效的政策以解决种族差异。考虑到BMI的社会形态和其他生活方式习惯，SEP和BMI的结果可能正在衡量相同的效果。在这篇综述中，作者对流行病学在促进进一步研究中的作用提出了建议，以更好地指导制定有效的政策以解决种族差异。考虑到BMI的社会形态和其他生活方式习惯，SEP和BMI的结果可能正在衡量相同的效果。在这篇综述中，作者对流行病学在促进进一步研究中的作用提出了建议，以更好地指导制定有效的政策以解决种族差异。