Sherman Mark E, Carreon Joseph D, Lacey James V, Devesa Susan S
Hormonal and Reproductive Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
J Natl Cancer Inst. 2005 Nov 16;97(22):1700-2. doi: 10.1093/jnci/dji378.
In the United States, endometrial carcinoma incidence rates, uncorrected for hysterectomy prevalence, are higher among white women than black women. We estimated corrected endometrial carcinoma rates by racial/ethnic groups and age (30-74 years) for 1992-2000 using data from the Surveillance, Epidemiology, and End Results program and the Behavioral Risk Factor Surveillance Survey. Hysterectomy prevalence was higher among black women than among Hispanic and white non-Hispanic women. Correcting for hysterectomy prevalence increased age-adjusted endometrial carcinoma rates per 10(5) woman-years from 29.2 to 48.7 (66.8% increase) overall, from 14.6 to 28.5 (95.3% increase) in blacks, from 18.8 to 29.6 (57.6% increase) in Hispanics, and from 33.2 to 54.9 (65.1%) in white non-Hispanics. This correction reduced the rate ratio for white non-Hispanics compared with blacks from 2.27 to 1.93. Among blacks but not Hispanics or white non-Hispanics, the endometrial carcinoma risk factors of obesity and diabetes were more prevalent among hysterectomized than nonhysterectomized women. Failure to correct for hysterectomy prevalence may lead to underestimates of endometrial carcinoma risk, especially among blacks. The high prevalence of hysterectomy among blacks with strong endometrial cancer risk factors may partly account for lower cancer rates in this group.
在美国，未根据子宫切除术患病率进行校正时，白人女性的子宫内膜癌发病率高于黑人女性。我们利用监测、流行病学和最终结果计划以及行为危险因素监测调查的数据，估算了1992 - 2000年按种族/族裔群体和年龄（30 - 74岁）校正后的子宫内膜癌发病率。黑人女性的子宫切除术患病率高于西班牙裔和非西班牙裔白人女性。校正子宫切除术患病率后，每10（5）女性年的年龄调整后子宫内膜癌发病率总体从29.2增至48.7（增加66.8%），黑人从14.6增至28.5（增加95.3%），西班牙裔从18.8增至29.6（增加57.6%），非西班牙裔白人从33.2增至54.9（增加65.1%）。这种校正使非西班牙裔白人与黑人的发病率比从2.27降至1.93。在黑人中，而非西班牙裔或非西班牙裔白人中，肥胖和糖尿病这些子宫内膜癌危险因素在接受子宫切除术的女性中比未接受子宫切除术的女性更普遍。未校正子宫切除术患病率可能导致低估子宫内膜癌风险，尤其是在黑人中。黑人中子宫切除术患病率高且子宫内膜癌危险因素强，可能部分解释了该群体癌症发病率较低的原因。
