California Cancer Registry, Public Health Institute, Sacramento, CA 95825, USA.
Cancer Causes Control. 2010 Oct;21(10):1721-30. doi: 10.1007/s10552-010-9601-y. Epub 2010 Jun 22.
Very few studies have simultaneously examined incidence of the leading cancers in relation to socioeconomic status (SES) and race/ethnicity in populations including Hispanics and Asians. This study aims to describe SES disparity in cancer incidence within each of four major racial/ethnic groups (non-Hispanic white, black, Hispanic, and Asian/Pacific Islander) for five major cancer sites, including female breast cancer, colorectal cancer, cervical cancer, lung cancer, and prostate cancer.
Invasive cancers of the five major sites diagnosed from 1998 to 2002 (n = 376,158) in California were included in the study. Composite area-based SES measures were used to quantify SES level and to calculate cancer incidence rates stratified by SES. Relative index of inequality (RII) was generated to measure SES gradient of cancer incidence within each racial/ethnic group.
Significant variations were detected in SES disparities across the racial/ethnic groups for all five major cancer sites. Female breast cancer and prostate cancer incidence increased with increased SES in all groups, with the trend strongest among Hispanics. Incidence of cervical cancer increased with decreased SES, with the largest gradient among non-Hispanic white women. Lung cancer incidence increased with decreased SES with the exception of Hispanic men and women, for whom SES gradient was in the opposite direction. For colorectal cancer, higher incidence was associated with lower SES in non-Hispanic whites but with higher SES in Hispanics and Asian/Pacific Islander women.
Examining SES disparity stratified by race/ethnicity enhances our understanding of the complex relationships between cancer incidence, SES, and race/ethnicity.
在包括西班牙裔和亚裔人群在内的人群中，很少有研究同时考察与社会经济地位（SES）和种族/民族相关的主要癌症的发病率。本研究旨在描述四个主要种族/民族群体（非西班牙裔白人、黑种人、西班牙裔和亚洲/太平洋岛民）中五种主要癌症部位（女性乳腺癌、结直肠癌、宫颈癌、肺癌和前列腺癌）中癌症发病率的 SES 差异。
本研究纳入了加利福尼亚州 1998 年至 2002 年间诊断出的五种主要部位的侵袭性癌症（n=376158）。使用综合区域 SES 衡量标准来量化 SES 水平，并按 SES 分层计算癌症发病率。相对不平等指数（RII）用于衡量每个种族/民族群体内部 SES 与癌症发病率之间的梯度关系。
在所有五个主要癌症部位中，不同种族/民族群体之间的 SES 差异存在显著差异。女性乳腺癌和前列腺癌的发病率在所有群体中随 SES 增加而增加，西班牙裔人群的趋势最强。宫颈癌的发病率随 SES 降低而增加，非西班牙裔白人女性的梯度最大。除了西班牙裔男性和女性，肺癌的发病率随 SES 降低而增加，其 SES 梯度方向相反。对于结直肠癌，非西班牙裔白人的发病率与 SES 呈负相关，但在西班牙裔和亚洲/太平洋岛民女性中与 SES 呈正相关。
按种族/民族分层检查 SES 差异，可增强我们对癌症发病率、SES 和种族/民族之间复杂关系的理解。
