Department of Surgery, Division of Urology, University of Arizona, Tucson, AZ.
Department of Surgery, Division of Urology, University of Arizona, Tucson, AZ.
Clin Genitourin Cancer. 2018 Jun;16(3):e535-e541. doi: 10.1016/j.clgc.2018.01.006. Epub 2018 Feb 12.
Cancer disparities in Native Americans (NAs) and Hispanic Americans (HAs) vary significantly in terms of cancer incidence and mortality rates across geographic regions. This review reports that kidney and renal pelvis cancers are unevenly affecting HAs and NAs compared to European Americans of non-Hispanic origin, and that currently there is significant need for improved data and reporting to be able to advance toward genomic-based precision medicine for the assessment of such cancers in these medically underserved populations. More specifically, in states along the US-Mexico border, HAs and NAs have higher kidney cancer incidence rates as well as a higher prevalence of kidney cancer risk factors, including obesity and chronic kidney disease. They are also more likely to receive suboptimal care compared to European Americans. Furthermore, they are underrepresented in epidemiologic, clinical, and molecular genomic studies of kidney cancer. Therefore, we maintain that progress in precision medicine for kidney cancer care requires an understanding of various factors among HAs and NAs, including the real kidney cancer burden, variations in clinical care, issues related to access to care, and specific clinical and molecular characteristics.
美国原住民（NAs）和西班牙裔美国人（HAs）的癌症差异在不同地理区域的癌症发病率和死亡率方面存在显著差异。这篇综述报告指出，与非西班牙裔欧洲裔美国人相比，哈维和 NAs 的肾和肾盂癌的发病率不均匀，目前非常需要改善数据和报告，以便能够朝着基于基因组的精准医学迈进，以评估这些医疗服务不足人群中的此类癌症。更具体地说，在美国与墨西哥边境的各州，哈维和 NAs 的肾癌发病率较高，肾癌风险因素的流行率也较高，包括肥胖和慢性肾脏病。与欧洲裔美国人相比，他们也更有可能接受不充分的治疗。此外，他们在肾癌的流行病学、临床和分子基因组研究中代表性不足。因此，我们认为，精准医学在肾癌治疗方面的进展需要了解 HAs 和 NAs 中的各种因素，包括实际的肾癌负担、临床护理的差异、获得护理的相关问题以及特定的临床和分子特征。
