Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico.
Infect Agent Cancer. 2010 May 14;5:10. doi: 10.1186/1750-9378-5-10.
In 2002, 17.8% of the global cancer burden was attributable to infections. This study assessed the age-standardized incidence and mortality rates of stomach, liver, and cervical cancer in Puerto Rico (PR) for the period 1992-2003 and compared them to those of Hispanics (USH), non-Hispanic Whites (NHW), and non-Hispanic Blacks (NHB) in the United States (US).
Age-standardized rates [ASR(World)] were calculated based on cancer incidence and mortality data from the PR Cancer Central Registry and SEER, using the direct method and the world population as the standard. Annual percent changes (APC) were calculated using the Poisson regression model from 1992-2003.
The incidence and mortality rates from stomach, liver and cervical cancer were lower in NHW than PR; with the exception of mortality from cervical cancer which was similar in both populations. Meanwhile, the incidence rates of stomach, liver and cervical cancers were similar between NHB and PR; except for NHB women who had a lower incidence rate of liver cancer than women in PR. NHB had a lower mortality from liver cancer than persons in PR, and similar mortality from stomach cancer.
The burden of liver, stomach, and cervical cancer in PR compares to that of USH and NHB and continues to be a public health priority. Public health efforts are necessary to further decrease the burden of cancers associated to infections in these groups, the largest minority population groups in the US. Future studies need to identify factors that may prevent infections with cancer-related agents in these populations. Strategies to increase the use of preventive strategies, such as vaccination and screening, among minority populations should also be developed.
2002 年,全球癌症负担的 17.8%归因于感染。本研究评估了 1992-2003 年波多黎各(PR)胃癌、肝癌和宫颈癌的年龄标准化发病率和死亡率,并将其与美国(US)的西班牙裔(USH)、非西班牙裔白人(NHW)和非西班牙裔黑人(NHB)进行了比较。
根据 PR 癌症中央登记处和 SEER 的癌症发病率和死亡率数据,使用直接法和世界人口作为标准,计算年龄标准化率[ASR(World)]。使用泊松回归模型从 1992-2003 年计算年百分变化(APC)。
NHW 的胃癌、肝癌和宫颈癌发病率和死亡率均低于 PR;宫颈癌死亡率除外,两者相似。同时,NHB 的胃癌、肝癌和宫颈癌发病率与 PR 相似;除了 NHB 女性的肝癌发病率低于 PR 女性外。NHB 的肝癌死亡率低于 PR 人群,胃癌死亡率相似。
PR 的肝癌、胃癌和宫颈癌负担与 USH 和 NHB 相似,仍是公共卫生的重点。需要采取公共卫生措施,进一步降低这些人群中与感染相关的癌症负担,这些人群是美国最大的少数族裔群体。未来的研究需要确定可能预防这些人群中与癌症相关的感染的因素。还应制定增加少数族裔人群中预防策略(如疫苗接种和筛查)使用的策略。