早期结肠直肠癌生存率的种族和民族差异
Joshua Demb1,2, Scarlett L Gomez3,4, Alison J Canchola3
1Division of Gastroenterology, Department of Internal Medicine, University of California, San Diego, La Jolla.
JAMA network open
|November 22, 2024
概括
早期结直肠癌 (EOCRC) 死亡率在夏威夷原住民或其他太平洋岛民和非西班牙裔黑人人口中较高. 健康的社会决定因素导致了EOCRC结果的这些差异.
科学领域:
- 在瘤学瘤学.
- 流行病学 流行病学
- 健康差异 在健康上的差异
背景情况:
- 早期结直肠癌 (EOCRC) 的发病率正在上升,种族和民族之间存在显著差异.
- 关于EOCRC死亡率差异的数据有限,特别是在对少数群体进行分类时.
研究的目的:
- 调查EOCRC死亡率中的种族和民族差异.
- 分析临床和社会人口学因素对这些死亡率差异的影响.
- 提供有关夏威夷原住民或其他太平洋岛民以及各种亚裔美国人群体的具体数据.
主要方法:
- 基于人口的队列研究,使用加利福尼亚癌症登记数据 (2000-2019).
- 包括被诊断患有EOCRC的18-49岁的个人.
- 考克斯比例危险回归模型被用于评估种族/种族和死亡率之间的关联,并对共变量进行了顺序调整.
主要成果:
- 与非西班牙裔白人个人相比,在夏威夷原住民或其他太平洋岛民 (AHR, 1.34) 和非西班牙裔黑人 (AHR, 1.18) 群体中观察到较高的EOCRC死亡率.
- 在最初的模型中,西班牙裔个体的死亡率较高,但在调整邻里社会经济地位后,这种情况消失了.
- 亚裔美国人群体的分类显示异质性,在完全调整后,没有一个单一群体显示死亡率增加.
结论:
- EOCRC死亡率的种族和种族差异很大,特别影响了夏威夷原住民或其他太平洋岛民和非西班牙裔黑人个体.
- 健康的社会决定因素在解释这些观察到的死亡率差异方面发挥着至关重要的作用.
- 需要针对社会和经济因素的有针对性的干预措施来减少EOCRC的差异.
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