Hsu Chiehwen Ed, Mas Francisco Soto, Miller Jerry A, Nkhoma Ella T
Department of Public and Community Health, University of Maryland College Park, College Park, MD, USA.
J Natl Med Assoc. 2007 Jan;99(1):72-80, 85-7.
Prostate cancer mortality disparities exist among racial/ethnic groups in the United States, yet few studies have explored the spatiotemporal trend of the disease burden. To better understand mortality disparities by geographic regions over time, the present study analyzed the geographic variations of prostate cancer mortality by three Texas racial/ethnic groups over a 22-year period.
The Spatial Scan Statistic developed by Kulldorff et al was used. Excess mortality was detected using scan windows of 50% and 90% of the study period and a spatial cluster size of 50% of the population at risk. Time trend was analyzed to examine the potential temporal effects of clustering. Spatial queries were used to identify regions with multiple racial/ethnic groups having excess mortality.
The most likely area of excess mortality for blacks occurred in Dallas-Metroplex and upper east Texas areas between 1990 and 1999; for Hispanics, in central Texas between 1992 and 1996: and for non-Hispanic whites, in the upper south and west to central Texas areas between 1990 and 1996. Excess mortality persisted among all racial/ethnic groups in the identified counties. The second scan revealed that three counties in west Texas presented an excess mortality for Hispanics from 1980-2001. Many counties bore an excess mortality burden for multiple groups. There is no time trend decline in prostate cancer mortality for blacks and non-Hispanic whites in Texas.
Disparities in prostate cancer mortality among racial/ethnic groups existed in Texas. Central Texas counties with excess mortality in multiple subgroups warrant further investigation.
美国不同种族/族裔群体之间存在前列腺癌死亡率差异，但很少有研究探讨疾病负担的时空趋势。为了更好地了解不同地理区域随时间推移的死亡率差异，本研究分析了22年间德克萨斯州三个种族/族裔群体前列腺癌死亡率的地理变化。
使用了Kulldorff等人开发的空间扫描统计方法。使用研究期50%和90%的扫描窗口以及50%的高危人群空间聚类大小来检测超额死亡率。分析时间趋势以检查聚类的潜在时间效应。使用空间查询来识别多个种族/族裔群体存在超额死亡率的区域。
黑人超额死亡率最可能出现的区域是1990年至1999年期间的达拉斯都会区和德克萨斯州东部上游地区；西班牙裔为1992年至1996年期间的德克萨斯州中部地区；非西班牙裔白人为1990年至1996年期间的德克萨斯州南部上游地区以及从西部到中部地区。在已确定的县中，所有种族/族裔群体都存在超额死亡率。第二次扫描显示，1980 - 2001年期间，德克萨斯州西部的三个县西班牙裔存在超额死亡率。许多县承受着多个群体的超额死亡负担。德克萨斯州的黑人和非西班牙裔白人前列腺癌死亡率没有时间趋势下降。
德克萨斯州不同种族/族裔群体之间存在前列腺癌死亡率差异。多个亚组存在超额死亡率的德克萨斯州中部各县值得进一步调查。
