前列腺癌流行病学的种族和民族差异在VA的疾病州
Shannon R Stock1,2, Michael T Burns1, Justin Waller1
1Department of Surgery, Durham VA Health Care System, Durham, North Carolina.
JAMA network open
|November 15, 2024
概括
与白人患者相比,黑人患者患前列腺癌 (PC) 的发病率是所有前列腺癌 (PC) 的两倍多. 虽然在黑人和西班牙裔个体的早期阶段,进展风险更高,但在晚期阶段更低,这表明PC的复杂种族差异.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 流行病学 流行病学
背景情况:
- 由于PSA测试,新型成像和新的治疗方法,前列腺癌 (PC) 护理已取得显著进展.
- 这些进展对PC流行病学和跨疾病状态的种族差异的影响需要进一步探索.
研究的目的:
- 分析各种前列腺癌 (PC) 流行病学的种族和种族差异.
- 特别调查非转移性激素敏感PC (nmHSPC),转移性HSPC (mHSPC),非转移性割耐药PC (nmCRPC) 和转移性CRPC (mCRPC).
主要方法:
- 从2012年至2020年,对男性美国退伍军人 (40岁以上) 进行了回顾性,基于人口的队列研究,并通过2021年进行跟踪.
- 分析包括年龄调整的发病率 (IR) 和按种族和种族 (黑人,白人,西班牙裔) 的点流行率.
- 使用结点回归评估趋势;使用竞争性风险模型分析疾病进展或死亡的时间.
主要成果:
- 包括6,539,001名退伍军人;476,227人患有PC.
- 与白人患者相比,黑人患者对所有PC状态的相对风险高出2倍以上.
- 在nmHSPC中,黑人和西班牙裔患者的mHSPC和nmCRPC的进展风险高于白人患者;然而,在mCRPC中,黑人和西班牙裔患者的死亡风险较低.
结论:
- 与白人退伍军人相比,黑人退伍军人表现出所有PC疾病状态的不成比例的高发病率.
- 进展风险因种族和疾病阶段而异,黑人和西班牙裔患者在早期阶段面临更高的风险,但在晚期风险较低.
- 尽管有平等的护理机会,但在前列腺癌发病率和进展模式方面仍然存在显著的种族差异.
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