National Institute on Minority Health and Health Disparities, Bethesda, Maryland.
Genetics Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland.
Am J Pathol. 2018 Feb;188(2):317-328. doi: 10.1016/j.ajpath.2017.10.009. Epub 2017 Nov 11.
The burden of cancer in the United States is unevenly spread across its different populations, with stark differences in both disease prevalence and outcome on the basis of race and ethnicity. Although a large portion of these differences can be explained by a variety of sociobehavioral and socioeconomic factors, even after these exposures are taken into consideration, considerable disparities persist. In this review, we explore a conceptual framework of biological theories and unifying concepts, based on an evolutionary perspective, that may help better define common guiding principles for exploration of underlying causes of cancer health disparities. The ultimate goal of this conceptual perspective is to outline approaches that may aid in establishing integrated pathway and processes analyses to provide useful insights to guide the development of future interventions. These interventions will improve outcome, increase prevention, and ultimately eliminate all disparities.
美国的癌症负担在不同人群中分布不均,基于种族和民族的疾病流行率和预后存在明显差异。尽管这些差异的很大一部分可以用各种社会行为和社会经济因素来解释,但即使考虑到这些因素,仍然存在相当大的差距。在这篇综述中,我们探讨了一个基于进化观点的生物理论和统一概念的概念框架,这可能有助于更好地定义探索癌症健康差异潜在原因的共同指导原则。这一概念观点的最终目标是概述方法,以帮助建立综合途径和过程分析,为指导未来干预措施的发展提供有用的见解。这些干预措施将改善结果、增加预防,并最终消除所有差异。