Wong Emily Chu Lee, Kapoor Anil
McMaster Institute of Urology, Division of Urology, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Can Urol Assoc J. 2017 May;11(5):E222-E232. doi: 10.5489/cuaj.4185. Epub 2017 May 9.
Prostate and kidney cancer rates in the Aboriginal population of Canada is a growing issue.
A systematic review of prostate and kidney cancer epidemiology in the Aboriginal population of Canada was performed with international comparison and evaluation of present epidemiological disparities. PubMed, Medline, and Embase (from January 1946 to June 2016), relevant government-published reports, and the websites of organizations contributing to prostate or kidney cancer guidelines were searched. We included studies that informed any of the three epidemiological questions this review is focused on answering.
Two systematic reviews, two meta-analyses, five literature reviews, and 21 single-study papers were included. The incidence and mortality rates of kidney cancer were elevated among Canadian Aboriginals when compared to the provincial or national population and to several international regions. No studies reported data on survival. Prostate cancer incidence, mortality, and survival rates were lower in Aboriginals provincially, nationally, and internationally, with incidence and survival reaching statistical significance. Elevated rate of risk factors for kidney cancer was a significant finding among Canadian Aboriginals. Aboriginals were screened for prostate cancer less than the general Canadian population, a trend also observed in the U.S.
The elevated incidence and mortality of kidney cancer among Canadian Aboriginals is most likely attributable to the rise in lifestyle-based risk factors. Two correlations concerning prostate cancer are made. However, due to temporal and regional disparities in data, further investigation is required to elucidate these observations.
加拿大原住民群体中前列腺癌和肾癌的发病率是一个日益严重的问题。
对加拿大原住民群体中前列腺癌和肾癌的流行病学进行了系统综述,并与国际数据进行比较,评估当前的流行病学差异。检索了PubMed、Medline和Embase(1946年1月至2016年6月)、相关政府发布的报告以及参与制定前列腺癌或肾癌指南的组织的网站。我们纳入了能回答本综述重点关注的三个流行病学问题中任何一个的研究。
纳入了两项系统综述、两项荟萃分析、五项文献综述和21篇单项研究论文。与省级或全国人口以及几个国际地区相比,加拿大原住民中肾癌的发病率和死亡率有所升高。没有研究报告生存数据。在省级、全国和国际范围内,原住民的前列腺癌发病率、死亡率和生存率较低,发病率和生存率具有统计学意义。肾癌危险因素的高发生率是加拿大原住民中的一个重要发现。原住民接受前列腺癌筛查的比例低于加拿大普通人群,美国也观察到了这一趋势。
加拿大原住民中肾癌发病率和死亡率的升高很可能归因于基于生活方式的危险因素的增加。得出了关于前列腺癌的两种相关性。然而,由于数据存在时间和地区差异,需要进一步调查以阐明这些观察结果。