癌症死亡率中的黑人异质性:美国黑人、海地人和牙买加人。
Black Heterogeneity in Cancer Mortality: US-Blacks, Haitians, and Jamaicans.
作者信息
Pinheiro Paulo S, Callahan Karen E, Ragin Camille, Hage Robert W, Hylton Tara, Kobetz Erin N
机构信息
University of Nevada Las Vegas, School of Community Health Sciences, African-Caribbean Cancer Consortium, Las Vegas, NV, USA.
出版信息
Cancer Control. 2016 Oct;23(4):347-358. doi: 10.1177/107327481602300406.
INTRODUCTION
The quantitative intraracial burden of cancer incidence, survival and mortality within black populations in the United States is virtually unknown.
METHODS
We computed cancer mortality rates of US- and Caribbean-born residents of Florida, specifically focusing on black populations (United States, Haiti, Jamaica) and compared them using age-adjusted mortality ratios obtained from Poisson regression models. We compared the mortality of Haitians and Jamaicans residing in Florida to populations in their countries of origin using Globocan.
RESULTS
We analyzed 185,113 cancer deaths from 2008 to 2012, of which 20,312 occurred in black populations. The overall risk of death from cancer was 2.1 (95% CI: 1.97-2.17) and 1.6 (95% CI: 1.55-1.71) times higher for US-born blacks than black Caribbean men and women, respectively (P < .001).
CONCLUSIONS
Race alone is not a determinant of cancer mortality. Among all analyzed races and ethnicities, including Whites and Hispanics, US-born blacks had the highest mortality rates while black Caribbeans had the lowest. The biggest intraracial difference was observed for lung cancer, for which US-blacks had nearly 4 times greater mortality risk than black Caribbeans. Migration from the islands of Haiti and Jamaica to Florida resulted in lower cancer mortality for most cancers including cervical, stomach, and prostate, but increased or stable mortality for 2 obesity-related cancers, colorectal and endometrial cancers. Mortality results in Florida suggest that US-born blacks have the highest incidence rate of "aggressive" prostate cancer in the world, rather than Caribbean men.
引言
美国黑人人群中癌症发病率、生存率和死亡率的种族内部定量负担几乎无人知晓。
方法
我们计算了佛罗里达州出生于美国和加勒比地区的居民的癌症死亡率,特别关注黑人人群(美国、海地、牙买加),并使用泊松回归模型得出的年龄调整死亡率比值进行比较。我们使用全球癌症负担数据(Globocan)将居住在佛罗里达州的海地人和牙买加人的死亡率与他们原籍国的人群进行比较。
结果
我们分析了2008年至2012年期间的185,113例癌症死亡病例,其中20,312例发生在黑人人群中。美国出生的黑人因癌症死亡的总体风险分别比加勒比地区出生的黑人男性和女性高2.1倍(95%置信区间:1.97 - 2.17)和1.6倍(95%置信区间:1.55 - 1.71)(P <.001)。
结论
种族本身并非癌症死亡率的决定因素。在所有分析的种族和族裔中,包括白人和西班牙裔,美国出生的黑人死亡率最高,而加勒比地区出生的黑人死亡率最低。在肺癌方面观察到最大的种族内部差异,美国黑人的肺癌死亡风险几乎是加勒比地区出生的黑人的4倍。从海地和牙买加岛屿移民到佛罗里达州导致大多数癌症(包括宫颈癌、胃癌和前列腺癌)的癌症死亡率降低,但与肥胖相关的两种癌症(结直肠癌和子宫内膜癌)的死亡率增加或保持稳定。佛罗里达州的死亡率结果表明,美国出生的黑人而非加勒比地区男性拥有世界上“侵袭性”前列腺癌的最高发病率。