Joseph Djenaba A, Johnson Chris J, White Arica, Wu Manxia, Coleman Michel P
Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
Cancer Data Registry of Idaho, Idaho Hospital Association, Boise, Idaho.
Cancer. 2017 Dec 15;123 Suppl 24(Suppl 24):5037-5058. doi: 10.1002/cncr.30882.
In the first CONCORD study, 5-year survival for patients with diagnosed with rectal cancer between 1990 and 1994 was <60%, with large racial disparities noted in the majority of participating states. We have updated these findings to 2009 by examining population-based survival by stage of disease at the time of diagnosis, race, and calendar period.
Data from the CONCORD-2 study were used to compare survival among individuals aged 15 to 99 years who were diagnosed in 37 states encompassing up to 80% of the US population. We estimated net survival up to 5 years after diagnosis correcting for background mortality with state-specific and race-specific life table. Survival estimates were age-standardized with the International Cancer Survival Standard weights. We present survival estimates by race (all, black, and white) for 2001 through 2003 and 2004 through 2009 to account for changes in collecting the data for Surveillance, Epidemiology, and End Results Summary Stage 2000.
There was a small increase in 1-year, 3-year, and 5-year net survival between 2001-2003 (84.6%, 70.7%, and 63.2%, respectively), and 2004-2009 (85.1%, 71.5%, and 64.1%, respectively). Black individuals were found to have lower 1-year, 3-year, and 5-year survival than white individuals in both periods; the absolute difference in survival between black and white individuals declined only for 5-year survival. Black patients had lower 5-year survival than whites at each stage at the time of diagnosis in both time periods.
There was little improvement noted in net survival for patients with rectal cancer, with persistent disparities noted between black and white individuals. Additional investigation is needed to identify and implement effective interventions to ensure the consistent and equitable use of high-quality screening, diagnosis, and treatment to improve survival for patients with rectal cancer. Cancer 2017;123:5037-58. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
在第一项CONCORD研究中，1990年至1994年期间被诊断为直肠癌的患者5年生存率<60%，在大多数参与州存在明显的种族差异。我们通过研究诊断时疾病分期、种族和日历时间的基于人群的生存率，将这些结果更新至2009年。
CONCORD-2研究的数据用于比较37个州中年龄在15至99岁之间被诊断为直肠癌的个体的生存率，这些州涵盖了美国高达80%的人口。我们使用特定州和特定种族的生命表校正背景死亡率，估计诊断后长达5年的净生存率。生存率估计值采用国际癌症生存标准权重进行年龄标准化。我们给出了2001年至2003年以及2004年至2009年按种族（所有、黑人、白人）划分的生存率估计值，以考虑监测、流行病学和最终结果总结第2000阶段数据收集方面的变化。
2001 - 2003年（分别为84.6%、70.7%和63.2%）与2004 - 2009年（分别为85.1%、71.5%和64.1%）之间，1年、3年和5年净生存率有小幅提高。在这两个时期，发现黑人个体的1年、3年和5年生存率均低于白人个体；黑人和白人个体之间的生存绝对差异仅在5年生存率方面有所下降。在两个时间段内，黑人患者在诊断时各阶段的5年生存率均低于白人。
直肠癌患者的净生存率几乎没有改善，黑人和白人个体之间的差异仍然存在。需要进一步调查以确定并实施有效的干预措施，确保高质量筛查、诊断和治疗的一致且公平使用，以提高直肠癌患者的生存率。《癌症》2017年；123:5037 - 58。2017年发表。本文为美国政府作品，在美国属于公共领域。
