Wilson Reda J, Ryerson A Blythe, Singh Simple D, King Jessica B
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
Cancer Epidemiol Biomarkers Prev. 2016 Feb;25(2):250-8. doi: 10.1158/1055-9965.EPI-15-0946. Epub 2016 Jan 27.
Limited literature is available about cancer in the Appalachian Region. This is the only known analysis of all cancers for Appalachia and non-Appalachia covering 100% of the US population. Appalachian cancer incidence and trends were evaluated by state, sex, and race and compared with those found in non-Appalachian regions.
US counties were identified as Appalachian or non-Appalachian. Age-adjusted cancer incidence rates, standard errors, and confidence intervals were calculated using the most recent data from the United States Cancer Statistics for 2004 to 2011.
Generally, Appalachia carries a higher cancer burden compared with non-Appalachia, particularly for tobacco-related cancers. For all cancer sites combined, Appalachia has higher rates regardless of sex, race, or region. The Appalachia and non-Appalachia cancer incidence gap has narrowed, with the exception of oral cavity and pharynx, larynx, lung and bronchus, and thyroid cancers.
Higher cancer incidence continues in Appalachia and appears at least in part to reflect high tobacco use and potential differences in socioeconomic status, other risk factors, patient health care utilization, or provider practices. It is important to continue to evaluate this population to monitor results from screening and early detection programs, understand behavioral risk factors related to cancer incidence, increase efforts to reduce tobacco use and increase cancer screening, and identify other areas where effective interventions may mediate disparities.
Surveillance and evaluation of special populations provide means to monitor screening and early detection programs, understand behavioral risk factors, and increase efforts to reduce tobacco use to mediate disparities.
关于阿巴拉契亚地区癌症的文献有限。这是对覆盖美国全部人口的阿巴拉契亚和非阿巴拉契亚地区所有癌症进行的唯一已知分析。按州、性别和种族对阿巴拉契亚地区的癌症发病率及趋势进行了评估，并与非阿巴拉契亚地区的情况进行了比较。
将美国各县划分为阿巴拉契亚或非阿巴拉契亚地区。利用美国癌症统计2004年至2011年的最新数据计算年龄调整后的癌症发病率、标准误差和置信区间。
总体而言，与非阿巴拉契亚地区相比，阿巴拉契亚地区的癌症负担更高，尤其是与烟草相关的癌症。对于所有癌症部位合并计算，无论性别、种族或地区，阿巴拉契亚地区的发病率都更高。阿巴拉契亚和非阿巴拉契亚地区的癌症发病率差距已经缩小，但口腔和咽部、喉、肺和支气管以及甲状腺癌除外。
阿巴拉契亚地区的癌症发病率仍然较高，这至少部分反映了烟草使用率高以及社会经济地位、其他风险因素、患者医疗保健利用或医疗服务提供者做法方面的潜在差异。继续对这一人群进行评估很重要，以便监测筛查和早期检测项目的结果，了解与癌症发病率相关的行为风险因素，加大减少烟草使用和增加癌症筛查的力度，并确定其他有效干预措施可能缩小差距的领域。
对特殊人群的监测和评估提供了监测筛查和早期检测项目、了解行为风险因素以及加大减少烟草使用力度以缩小差距的手段。
