Rim Sun Hee, Seeff Laura, Ahmed Faruque, King Jessica B, Coughlin Steven S
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Coordinating Center for Health Promotion, Center for Disease Control and Prevention, Atlanta, Georgia, USA.
Cancer. 2009 May 1;115(9):1967-76. doi: 10.1002/cncr.24216.
: By using recent national cancer surveillance data, the authors investigated colorectal cancer (CRC) incidence by subpopulation to inform the discussion of demographic-based CRC guidelines.
: Data included CRC incidence (1999-2004) from the combined National Program of Cancer Registries and Surveillance, Epidemiology, and End Results Program databases. Incidence rates (age-specific and age-adjusted to the 2000 US standard population) were reported among individuals ages 40 to 44 years, 45 to 49 years, 50 to 64 years, and > or =65 years by sex, subsite, disease stage, race, and ethnicity. Rate ratios (RR) and rate differences (RD) were calculated to compare CRC rates in different subpopulations.
: Incidence rates were greater among men compared with women and among blacks compared with whites and other races. Incidence rates among Asians/Pacific Islanders (APIs), American Indians/Alaska Natives (AI/ANs), and Hispanics consistently were lower than among whites and non-Hispanics. Sex disparities were greatest in the population aged > or =65 years, whereas racial disparities were more pronounced in the population aged <65 years. Although the RD between blacks and whites diminished at older ages, the RD between APIs and whites, between AI/ANs and whites, and between non-Hispanics and Hispanics increased with increasing age. By subsite, blacks had the highest incidence rates compared with whites and other races in the proximal and distal colon; the reverse was true in the rectum. By stage, whites had higher incidence rates than blacks and other races for localized and regional disease; for distant and unstaged disease, blacks had higher incidence rates than whites.
: The current findings suggested differences that can be considered in formulating targeted screening and other public health strategies to reduce disparities in CRC incidence in the United States. Cancer 2009. Published 2009 by the American Cancer Society.
通过使用近期的国家癌症监测数据，作者按亚人群调查了结直肠癌（CRC）发病率，以为基于人口统计学的CRC指南讨论提供信息。
数据包括来自癌症登记与监测国家计划以及监测、流行病学和最终结果计划数据库合并后的CRC发病率（1999 - 2004年）。报告了40至44岁、45至49岁、50至64岁以及≥65岁人群按性别、肿瘤部位、疾病分期、种族和族裔划分的发病率（年龄别发病率以及按2000年美国标准人群年龄调整后的发病率）。计算率比（RR）和率差（RD）以比较不同亚人群中的CRC发病率。
男性的发病率高于女性，黑人的发病率高于白人和其他种族。亚裔/太平洋岛民（API）、美洲印第安人/阿拉斯加原住民（AI/AN）和西班牙裔的发病率始终低于白人和非西班牙裔。年龄≥65岁人群中的性别差异最大，而种族差异在年龄＜65岁人群中更为明显。尽管黑人和白人之间的RD在老年时有所减小，但API与白人之间、AI/AN与白人之间以及非西班牙裔与西班牙裔之间的RD随年龄增长而增加。按肿瘤部位划分，黑人在近端和远端结肠的发病率高于白人和其他种族；在直肠则相反。按疾病分期划分，白人在局限性和区域性疾病中的发病率高于黑人和其他种族；在远处转移和未分期疾病中，黑人的发病率高于白人。
当前研究结果表明，在制定有针对性的筛查和其他公共卫生策略以减少美国CRC发病率差异时可考虑这些差异。《癌症》2009年。由美国癌症协会于2009年出版。
