Hobley James, Lengerich Eugene J, Lindsay Ii Jerome A, McGarrity Thomas J
Dr. Hobley is a Fellow, Dr. Lindsay is Resident Physician, and Dr. McGarrity serves as Chief and Graham H. Jeffries is Professor of Medicine in the Division of Gastroenterology and Hepatology, Department of Medicine, Milton S. Hershey Medical Center, at the Pennsylvania State University College of Medicine. Dr. Lengerich is Associate Professor in the Division of Epidemiology, Department of Health Evaluation Sciences, at Pennsylvania State University.
Gastroenterol Hepatol (N Y). 2006 Jul;2(7):498-502.
A disparity in colorectal cancer (CRC) incidence and mortality has been reported for black men and women in the United States. To determine the magnitude and direction of temporal change in black/white disparity, by anatomic subsites of the colon and rectum. Population-based, epidemiologic study. Pennsylvania, 1997-2002. Black/white ratios of the percentage of cases diagnosed at late stage and of age-adjusted incidence rates, by anatomic subsite, for four 3-year time periods. In 2000-2002, 54.6% of CRC cases among blacks were diagnosed at late stage, compared with 51.3% among whites. The percentage of cases in the cecum, transverse colon, splenic flexure, descending colon, sigmoid colon, rectum, and recto-sigmoid diagnosed at a late stage was larger among blacks than among whites. The disparity in the percentage of cases diagnosed at a late stage in the colon and rectum, transverse colon, and descending colon increased during the study period (<.05). In 2000-2002, incidence was greater among blacks (64.1/100,000) than among whites (59.8/100,000). Incidence for segments of the proximal colon tended to be higher among blacks than among whites. The disparity in the incidence in the transverse colon increased during the study period (=.021), while the increase in the disparity in the appendix approached statistical significance (=.051). The effect of race may have been confounded by unavailable data, including socioeconomic position. The black/white disparity in the percentage of cases diagnosed at late stage increased during the study period. The disparity in the percentage of cases diagnosed at a late stage and incidence for the transverse colon also increased. Efforts to increase screening for CRC, especially among blacks, should be enhanced.
据报道，美国黑人男性和女性在结直肠癌（CRC）的发病率和死亡率方面存在差异。为了确定按结肠和直肠的解剖亚部位划分的黑人/白人差异随时间变化的程度和方向，开展了一项基于人群的流行病学研究。研究地点为宾夕法尼亚州，时间跨度为1997年至2002年。分析了四个3年时间段内按解剖亚部位划分的晚期诊断病例百分比的黑人/白人比率以及年龄调整发病率。在2000 - 2002年期间，黑人中54.6%的CRC病例在晚期被诊断出来，而白人中的这一比例为51.3%。黑人在盲肠、横结肠、脾曲、降结肠、乙状结肠、直肠以及直肠 - 乙状结肠部位晚期诊断病例的百分比高于白人。在研究期间，结肠和直肠、横结肠以及降结肠部位晚期诊断病例百分比的差异有所增加（P <.05）。2000 - 2002年期间，黑人的发病率（64.1/100,000）高于白人（59.8/100,000）。近端结肠各段的发病率黑人往往高于白人。横结肠发病率的差异在研究期间有所增加（P =.021），而阑尾发病率差异的增加接近统计学显著性（P =.051）。种族的影响可能因包括社会经济地位在内的不可用数据而受到混淆。在研究期间，晚期诊断病例百分比的黑人/白人差异有所增加。横结肠晚期诊断病例百分比和发病率的差异也有所增加。应加强努力以增加CRC筛查，尤其是在黑人中。
