2001 - 2009年美国不同种族和分期的胃癌生存率：CONCORD - 2研究结果
Stomach cancer survival in the United States by race and stage (2001-2009): Findings from the CONCORD-2 study.
作者信息
Jim Melissa A, Pinheiro Paulo S, Carreira Helena, Espey David K, Wiggins Charles L, Weir Hannah K
机构信息
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
Epidemiology and Biostatistics, School of Community Health Sciences, University of Nevada-Las Vegas, Las Vegas, Nevada.
出版信息
Cancer. 2017 Dec 15;123 Suppl 24(Suppl 24):4994-5013. doi: 10.1002/cncr.30881.
BACKGROUND
Stomach cancer was a leading cause of cancer-related deaths early in the 20th century and has steadily declined over the last century in the United States. Although incidence and death rates are now low, stomach cancer remains an important cause of morbidity and mortality in black, Asian and Pacific Islander, and American Indian/Alaska Native populations.
METHODS
Data from the CONCORD-2 study were used to analyze stomach cancer survival among males and females aged 15 to 99 years who were diagnosed in 37 states covering 80% of the US population. Survival analyses were corrected for background mortality using state-specific and race-specific (white and black) life tables and age-standardized using the International Cancer Survival Standard weights. Net survival is presented up to 5 years after diagnosis by race (all, black, and white) for 2001 through 2003 and 2004 through 2009 to account for changes in collecting Surveillance, Epidemiology, and End Results Summary Stage 2000 data from 2004.
RESULTS
Almost one-third of stomach cancers were diagnosed at a distant stage among both whites and blacks. Age-standardized 5-year net survival increased between 2001 to 2003 and 2004 to 2009 (26.1% and 29%, respectively), and no differences were observed by race. The 1-year, 3-year, and 5-year survival estimates were 53.1%, 33.8%, and 29%, respectively. Survival improved in most states. Survival by stage was 64% (local), 28.2% (regional), and 5.3% (distant).
CONCLUSIONS
The current results indicate high fatality for stomach cancer, especially soon after diagnosis. Although improvements in stomach cancer survival were observed, survival remained relatively low for both blacks and whites. Primary prevention through the control of well-established risk factors would be expected to have the greatest impact on further reducing deaths from stomach cancer. Cancer 2017;123:4994-5013. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
背景
胃癌在20世纪初是癌症相关死亡的主要原因，在美国上个世纪其发病率稳步下降。尽管目前发病率和死亡率较低，但在黑人、亚裔和太平洋岛民以及美国印第安人/阿拉斯加原住民人群中，胃癌仍是发病和死亡的重要原因。
方法
来自CONCORD - 2研究的数据用于分析年龄在15至99岁之间、在覆盖美国80%人口的37个州被诊断为胃癌的男性和女性的生存情况。使用特定州和特定种族（白人和黑人）的生命表对生存分析进行背景死亡率校正，并使用国际癌症生存标准权重进行年龄标准化。按种族（所有、黑人、白人）呈现2001年至2003年以及2004年至2009年诊断后长达5年的净生存率，以考虑2004年收集监测、流行病学和最终结果总结第2000阶段数据的变化。
结果
白人和黑人中近三分之一的胃癌在远处阶段被诊断出来。年龄标准化的5年净生存率在2001年至2003年以及2004年至2009年之间有所提高（分别为26.1%和29%），且未观察到种族差异。1年、3年和5年生存率估计分别为53.1%、33.8%和29%。大多数州的生存率有所改善。按分期的生存率分别为64%（局部）、28.2%（区域）和5.3%（远处）。
结论
目前的结果表明胃癌致死率高，尤其是在诊断后不久。尽管观察到胃癌生存率有所改善，但黑人和白人的生存率仍然相对较低。通过控制已确定的危险因素进行一级预防有望对进一步降低胃癌死亡产生最大影响。《癌症》2017年；123:4994 - 5013。2017年发表。本文为美国政府作品，在美国属于公共领域。
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