Singh Gopal K, Williams Shanita D, Siahpush Mohammad, Mulhollen Aaron
US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, 5600 Fishers Lane, Room 18-41, Rockville, MD 20857, USA.
J Cancer Epidemiol. 2011;2011:107497. doi: 10.1155/2011/107497. Epub 2012 Feb 14.
We analyzed socioeconomic, rural-urban, and racial inequalities in US mortality from all cancers, lung, colorectal, prostate, breast, and cervical cancers. A deprivation index and rural-urban continuum were linked to the 2003-2007 county-level mortality data. Mortality rates and risk ratios were calculated for each socioeconomic, rural-urban, and racial group. Weighted linear regression yielded relative impacts of deprivation and rural-urban residence. Those in more deprived groups and rural areas had higher cancer mortality than more affluent and urban residents, with excess risk being marked for lung, colorectal, prostate, and cervical cancers. Deprivation and rural-urban continuum were independently related to cancer mortality, with deprivation showing stronger impacts. Socioeconomic inequalities existed for both whites and blacks, with blacks experiencing higher mortality from each cancer than whites within each deprivation group. Socioeconomic gradients in mortality were steeper in nonmetropolitan than in metropolitan areas. Mortality disparities may reflect inequalities in smoking and other cancer-risk factors, screening, and treatment.
我们分析了美国所有癌症、肺癌、结直肠癌、前列腺癌、乳腺癌和宫颈癌死亡率方面的社会经济、城乡以及种族不平等情况。一个贫困指数和城乡连续体与2003 - 2007年县级死亡率数据相关联。计算了每个社会经济、城乡和种族群体的死亡率及风险比。加权线性回归得出了贫困和城乡居住情况的相对影响。较贫困群体和农村地区的人比更富裕和城市居民的癌症死亡率更高，肺癌、结直肠癌、前列腺癌和宫颈癌的额外风险尤为明显。贫困和城乡连续体与癌症死亡率独立相关，贫困的影响更为显著。白人和黑人都存在社会经济不平等，在每个贫困组中，黑人每种癌症的死亡率都高于白人。非大都市地区死亡率的社会经济梯度比大都市地区更陡。死亡率差异可能反映了吸烟及其他癌症风险因素、筛查和治疗方面的不平等。
