Colorado School of Public Health, University of Colorado, Denver, Anschutz Medical Campus, Aurora, Colorado 80045, USA.
Annu Rev Public Health. 2010;31:121-32. doi: 10.1146/annurev.publhealth.121208.131047.
The close of the twentieth century brought historic changes in cancer risk factors, early detection, and treatment. As a consequence, we have seen two decades of steadily declining risk of death from cancer in the United States. The reasons for declining cancer mortality rates are largely known: reduced tobacco use, the adoption of cancer early-detection methods, and better cancer therapeutics. Despite this progress, disparities in cancer mortality persist across different groups defined by race and social class. Because all the factors that account for declining cancer trends are influenced strongly by social class, and because of large social class disparities in cancer risk factors, there will likely be a widening gap in cancer mortality among those in lower socioeconomic groups in the future. This article reviews the trends in risk factors for cancer mortality and discusses the persistent problem of disparities by race and social class.
二十世纪末期带来了癌症风险因素、早期检测和治疗方面的历史性变革。因此，我们看到美国癌症死亡率在过去二十年中稳步下降。癌症死亡率下降的原因主要是：吸烟减少、癌症早期检测方法的采用以及更好的癌症治疗方法。尽管取得了这些进展，但不同种族和社会阶层的人群之间的癌症死亡率仍存在差异。由于导致癌症趋势下降的所有因素都受到社会阶层的强烈影响，而且由于癌症风险因素在社会阶层之间存在巨大差异，未来社会经济地位较低的人群的癌症死亡率差距可能会进一步扩大。本文回顾了癌症死亡率风险因素的趋势，并讨论了种族和社会阶层差异这一持续存在的问题。
