Sloane Dana
Division of Gastroenterology, Washington Hospital Center, Washington, DC, USA.
Methods Mol Biol. 2009;471:65-83. doi: 10.1007/978-1-59745-416-2_4.
It is widely accepted that there is a differential burden of cancer in certain populations, including racial/ ethnic minorities, the medically underserved, and older adults. Differences in survival, stage at diagnosis, and risk of death have been identified in these populations for cancers of the lung, colon and rectum, prostate, and female breast. The factors that drive these disparities are not uniformly understood. Addressing the unique issue of racial differences in cancer epidemiology necessitates a discussion of the definitions of "race" and "ethniCity," and an analysis of the validity of these concepts within the context of scientific study. Poor cancer-related health outcomes in groups of low socioeconomic status highlight issues of access to care and preventive care use. There is a scant amount of data on cancer in the elderly, and the special considerations that this group faces. A unique challenge facing cancer epidemiologists is suboptimal recruitment of members of these groups into clinical studies, which precludes a robust understanding of the existing disparities. It is critical to appreciate the overlap that exists between these populations, because this may complicate data interpretation. Legislative efforts that have, in part, been driven by the National Center on Minority Health and Health Disparities and by the Department of Health and Human Services, will continue to play an instrumental role in the identification and resolution of cancer disparities in these groups.
人们普遍认为，某些人群，包括少数种族/族裔、医疗服务不足人群和老年人，患癌症的负担存在差异。在这些人群中，已发现肺癌、结肠直肠癌、前列腺癌和女性乳腺癌在生存率、诊断时的分期以及死亡风险方面存在差异。导致这些差异的因素尚未得到一致理解。解决癌症流行病学中种族差异这一独特问题需要讨论“种族”和“族裔”的定义，并在科学研究的背景下分析这些概念的有效性。社会经济地位较低群体中与癌症相关的不良健康结果凸显了获得医疗服务和使用预防保健方面的问题。关于老年人癌症以及该群体面临的特殊考虑因素的数据很少。癌症流行病学家面临的一个独特挑战是，这些群体的成员参与临床研究的招募情况不理想，这妨碍了对现有差异的深入了解。认识到这些人群之间存在的重叠至关重要，因为这可能会使数据解释变得复杂。部分由国家少数族裔健康与健康差异中心以及卫生与公众服务部推动的立法努力，将继续在识别和解决这些群体中的癌症差异方面发挥重要作用。
