Xie Shao-Hua, Rabbani Sirus, Petrick Jessica L, Cook Michael B, Lagergren Jesper
Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, the United States.
Am J Epidemiol. 2017 Dec 15;186(12):1341-1351. doi: 10.1093/aje/kwx221.
Racial and ethnic disparities in the incidence of esophageal cancer have not been thoroughly characterized with quantitative health-disparity measures. Using data from 1992-2013 from 13 US cancer registries in the Surveillance, Epidemiology, and End Results database, we assessed such disparities according to histological type, based on a variety of disparity metrics. The age-standardized incidence rate of squamous cell carcinoma (SCC) was highest among black persons, while adenocarcinoma mainly affected white men. The rate of SCC decreased over time in all racial/ethnic groups, and this was most pronounced in black persons (by 5.7% per year among men and 5.0% among women). The adenocarcinoma rate rose among non-Hispanic whites and among black men. Racial/ethnic disparities in the incidence of total esophageal cancer decreased over time, which was due mainly to reduced disparities in SCC. The 2 absolute disparity measures-range difference and between-group variance-for adenocarcinoma rose by 3.2% and 6.8% per year, respectively, in men and by 1.8% and 5.3% per year, respectively, in women. This study demonstrates decreased racial/ethnic disparities in the incidence of esophageal SCC over time in the United States, while disparities increased in adenocarcinoma incidence as measured on the absolute scale.
食管癌发病率的种族和族裔差异尚未通过定量的健康差异衡量标准得到充分描述。利用监测、流行病学和最终结果数据库中来自美国13个癌症登记处的1992 - 2013年数据，我们基于多种差异指标，根据组织学类型评估了此类差异。鳞状细胞癌（SCC）的年龄标准化发病率在黑人中最高，而腺癌主要影响白人男性。所有种族/族裔群体中SCC的发病率随时间下降，在黑人中最为明显（男性每年下降5.7%，女性每年下降5.0%）。非西班牙裔白人和黑人男性中的腺癌发病率上升。食管癌总发病率的种族/族裔差异随时间下降，这主要是由于SCC差异的缩小。腺癌的两项绝对差异衡量指标——范围差异和组间方差——在男性中分别每年上升3.2%和6.8%，在女性中分别每年上升1.8%和5.3%。这项研究表明，在美国，随着时间的推移，食管SCC发病率的种族/族裔差异有所下降，而从绝对尺度衡量，腺癌发病率的差异则有所增加。
