Cook Michael B, Rosenberg Philip S, McCarty Frances A, Wu Manxia, King Jessica, Eheman Christie, Anderson William F
Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland.
Prostate. 2015 May;75(7):758-63. doi: 10.1002/pros.22958. Epub 2015 Jan 25.
Black men have a higher incidence of prostate cancer than white men in the U.S., but little is known whether incidence or racial differences vary geographically. Understanding these differences may assist future studies on causes of prostate cancer. To address such, we leverage the unique resource of the National Program of Cancer Registries (NPCR) combined with Surveillance, Epidemiology and End Results (SEER).
Prostate cancer counts and population denominators by race (black, white), age, calendar year, and U.S. census division, for the period 1999-2008, were extracted from NPCR and SEER. We calculated age-standardized incidence rates (ASR) and estimated annual percent changes (EAPC) by race and census division. We assessed black-to-white incidence rate ratios (BWIRR) by census division and by calendar period.
This analysis included 1,713,471 prostate cancer cases and 1,217 million person-years. Black ASRs ranged from 176 per 100,000 person-years in Mountain division to 259 in Middle Atlantic. BWIRRs ranged from 1.20 in Western divisions to 1.72 in Southeastern divisions. EAPCs indicated that prostate cancer incidence is not decreasing in East South Central, unlike all other divisions. White EAPCs displayed similar variations by census division, resulting in modest temporal changes in BWIRRs.
Within the U.S., there exists significant geographic variability in prostate cancer incidence rates. Although there are large geographic differences in BWIRRs, temporal trends are fairly stable. This may indicate that primary factors affecting prostate cancer incidence rates vary geographically but affect both black and white men to a similar degree.
在美国，黑人男性前列腺癌的发病率高于白人男性，但对于发病率或种族差异是否存在地理差异知之甚少。了解这些差异可能有助于未来对前列腺癌病因的研究。为了解决这个问题，我们利用了癌症登记国家计划（NPCR）与监测、流行病学和最终结果（SEER）相结合的独特资源。
从NPCR和SEER中提取了1999 - 2008年期间按种族（黑人、白人）、年龄、日历年和美国人口普查分区划分的前列腺癌病例数和人口分母。我们计算了按种族和人口普查分区划分的年龄标准化发病率（ASR）和估计年变化百分比（EAPC）。我们评估了按人口普查分区和日历期划分的黑人与白人发病率比（BWIRR）。
该分析包括1,713,471例前列腺癌病例和12.17亿人年。黑人的ASR范围从山区每10万人年176例到中大西洋地区的259例。BWIRR范围从西部各分区的1.20到东南部各分区的1.72。EAPC表明，与所有其他分区不同，东中南部的前列腺癌发病率并未下降。白人的EAPC在不同人口普查分区也表现出类似的变化，导致BWIRR随时间有适度变化。
在美国境内，前列腺癌发病率存在显著的地理差异。尽管BWIRR存在较大的地理差异，但时间趋势相当稳定。这可能表明影响前列腺癌发病率的主要因素在地理上有所不同，但对黑人和白人男性影响程度相似。
