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新墨西哥州西班牙裔和非西班牙裔白人晚期结直肠癌的种族-族裔差异

Racial-Ethnic Disparities in Late-Stage Colorectal Cancer Among Hispanics and Non-Hispanic Whites of New Mexico.

作者信息

Gonzales Melissa, Qeadan Fares, Mishra Shiraz I, Rajput Ashwani, Hoffman Richard M

机构信息

1 University of New Mexico, Albuquerque, NM, USA.

2 University of Iowa, Iowa City, IA, USA.

出版信息

Hisp Health Care Int. 2017 Dec;15(4):180-188. doi: 10.1177/1540415317746317.

Abstract

INTRODUCTION

Hispanics in New Mexico are diagnosed with more later-stage colorectal cancer (CRC) than non-Hispanic Whites (NHW). Our study evaluated the interaction of race/ethnicity and risk factors for later-stage III and IV CRC among patients in New Mexico.

METHOD

CRC patients ages 30 to 75 years ( n = 163, 46% Hispanic) completed a survey on key explanatory clinical, lifestyle, preventive health, and demographic variables for CRC risk. Adjusted logistic regression models examined whether these variables differentially contributed to later-stage CRC among NHW versus Hispanics.

RESULTS

Compared with NHW, Hispanics had a higher prevalence of later-stage CRC ( p = .007), diabetes ( p = .006), high alcohol consumption ( p = .002), low education ( p = .003), and CRC diagnosis due to symptoms ( p = .06). Compared with NHW, Hispanics reporting high alcohol consumption (odds ratio [OR] = 7.59; 95% confidence interval [CI] = 1.31-43.92), lower education (OR = 3.5; 95% CI = 1.28-9.65), being nondiabetic (OR = 3.23; 95% CI = 1.46-7.15), or ever smokers (OR = 2.4; 95% CI = 1.03-5.89) were at higher risk for late-stage CRC. Adjusting for CRC screening did not change the direction or intensity of the odds ratios.

CONCLUSION

The ethnicity-risk factor interactions, identified for late-stage CRC, highlight significant factors for targeted intervention strategies aimed at reducing the burden of later-stage CRC among Hispanics in New Mexico with broad applicability to other Hispanic populations.

摘要

引言

新墨西哥州的西班牙裔比非西班牙裔白人(NHW)被诊断出更多的晚期结直肠癌(CRC)。我们的研究评估了新墨西哥州患者中种族/族裔与晚期III期和IV期CRC风险因素之间的相互作用。

方法

年龄在30至75岁之间的CRC患者(n = 163,46%为西班牙裔)完成了一项关于CRC风险的关键解释性临床、生活方式、预防健康和人口统计学变量的调查。调整后的逻辑回归模型检查了这些变量在NHW与西班牙裔中对晚期CRC的贡献是否存在差异。

结果

与NHW相比,西班牙裔晚期CRC的患病率更高(p = 0.007)、糖尿病患病率更高(p = 0.006)、高酒精消费量更高(p = 0.002)、教育程度较低(p = 0.003)以及因症状导致的CRC诊断率更高(p = 0.06)。与NHW相比,报告高酒精消费量的西班牙裔(优势比[OR] = 7.59;95%置信区间[CI] = 1.31 - 43.92)、教育程度较低(OR = 3.5;95% CI = 1.28 - 9.65)、非糖尿病患者(OR = 3.23;95% CI = 1.46 - 7.15)或曾经吸烟者(OR = 2.4;95% CI = 1.03 - 5.89)患晚期CRC的风险更高。调整CRC筛查后,优势比的方向和强度没有改变。

结论

为晚期CRC确定的种族 - 风险因素相互作用突出了旨在减轻新墨西哥州西班牙裔晚期CRC负担的有针对性干预策略的重要因素,这些策略广泛适用于其他西班牙裔人群。

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