Nishri E Diane, Sheppard Amanda J, Withrow Diana R, Marrett Loraine D
Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON.
Int J Cancer. 2015 Feb 1;136(3):639-45. doi: 10.1002/ijc.29024. Epub 2014 Jul 9.
We aimed to compare cancer survival in Ontario First Nations people to that in other Ontarians for five major cancer types: colorectal, lung, cervix, breast and prostate. A list of registered or "Status" Indians in Ontario was used to create a cohort of over 140,000 Ontario First Nations people. Cancers diagnosed in cohort members between 1968 and 2001 were identified from the Ontario Cancer Registry, with follow-up for death until December 31st, 2007. Flexible parametric modeling of the hazard function was used to compare the survival experience of the cohort to that of other Ontarians. We considered changes in survival from the first half of the time period (1968-1991) to the second half (1992-2001). For other Ontarians, survival had improved over time for every cancer site. For the First Nations cohort, survival improved only for breast and prostate cancers; it either declined or remained unchanged for the other cancers. For cancers diagnosed in 1992 or later, all-cause and cause-specific survival was significantly poorer for First Nations people diagnosed with breast, prostate, cervical, colorectal (male and female) and male lung cancers as compared to their non-First Nations peers. For female lung cancer, First Nations women appeared to have poorer survival; however, the result was not statistically significant. Ontario's First Nations population experiences poorer cancer survival when compared to other Ontarians and strategies to reduce these inequalities must be developed and implemented.
我们旨在比较安大略省原住民与其他安大略人在五种主要癌症类型（结直肠癌、肺癌、宫颈癌、乳腺癌和前列腺癌）方面的癌症生存率。利用安大略省登记在册的或具有“身份”的印第安人名单，创建了一个超过14万安大略省原住民的队列。从安大略癌症登记处识别出该队列成员在1968年至2001年期间诊断出的癌症，并随访至2007年12月31日的死亡情况。使用灵活的参数化危险函数模型来比较该队列与其他安大略人的生存经历。我们考虑了从时间段的前半段（1968 - 1991年）到后半段（1992 - 2001年）生存率的变化。对于其他安大略人，每个癌症部位的生存率都随时间有所提高。对于原住民队列，仅乳腺癌和前列腺癌的生存率有所提高；其他癌症的生存率要么下降，要么保持不变。对于1992年或之后诊断出的癌症，与非原住民同龄人相比，被诊断患有乳腺癌、前列腺癌、宫颈癌、结直肠癌（男性和女性）以及男性肺癌的原住民的全因生存率和特定病因生存率明显更低。对于女性肺癌，原住民女性的生存率似乎更低；然而，结果在统计学上并不显著。与其他安大略人相比，安大略省的原住民人口癌症生存率更低，必须制定并实施减少这些不平等现象的策略。
