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华盛顿特区非裔美国人历史人口中的癌症及其地理空间分布。

Cancer in an Historic Washington DC African American Population and Its Geospatial Distribution.

作者信息

Jackson Latifa, Jackson Hasan, Mohammed Mariam, Guthrie Nicholas, Kim Shihyun, Okolo Rita, Jackson Fatimah

机构信息

W. Montague Cobb Research Laboratory, Howard University, Washington, DC, United States.

Department of Pediatrics, College of Medicine, Howard University, Washington, DC, United States.

出版信息

Front Oncol. 2018 Nov 13;8:383. doi: 10.3389/fonc.2018.00383. eCollection 2018.

Abstract

Cancer continues to be a major cause of morbidity and mortality in the African American community but insights into the types and incidence of cancer 85 years ago have been virtually non-existent and little is known of its geospatial distribution. Historical information on cancer can shed light on current health disparities, particularly among African Americans. The aims of this study were to: (1) assess the frequencies of the cancer types present among Cobb Collection individuals; (2) compare these data with current research on cancer in African Americans; and (3) evaluate the pattern of cancer expression, including its geospatial distributions, as a cause of death between 1931 and 1969 in an historic African American subgroup and compare this pattern with the historic and contemporary patterns of cancer etiology and incidence. Systematic assessments of the existing clinical, demographic, and anatomical records in the Cobb Research Laboratory were made of individuals identified as dying from specific cancers from 1931 to 1969. These were compared with the national profiles of cancer during the historic time an individual died as well as the contemporary patterns of cancer deaths. Analysis of their residential addresses just prior to death were assessed using a commercial geographic information system. Each location was assigned a geospatial location and proximity between each site and clusters of sites were investigated. Seventeen different cancer types were found within 28 individuals of the Cobb Collection between 1931 and 1969. The cancer types with the highest frequencies were carcinoma of stomach, lung, esophagus, larynx and bronchogenic carcinoma. Eighty-four percent of all cancer incidents occurred in males and 76% were among individuals identified as African American. Seventy-one percent of the highest incidence cancers were among African American males. Geospatial clustering was observed most noticeably in the redistribution of carcinoma of the esophagus. Our results provide historical depth to our knowledge of the common cancer causes of morbidity among African Americans of Washington DC from 1931 to 1969. We contrast these findings with national historical data on cancer etiology and ethnic disparities in incidence. Our study suggests that historic data can provide longitudinal depth to our understanding of the persistence of cancer susceptibilities in a vulnerable subgroup.

摘要

癌症仍然是美国非裔社区发病和死亡的主要原因,但对于85年前癌症的类型和发病率几乎毫无见解,对其地理空间分布也知之甚少。有关癌症的历史信息能够揭示当前的健康差异,尤其是在美国非裔人群中。本研究的目的是:(1)评估科布收藏(Cobb Collection)中的个体所患癌症类型的频率;(2)将这些数据与当前关于美国非裔癌症的研究进行比较;(3)评估1931年至1969年间一个历史悠久的美国非裔亚组中作为死因的癌症表达模式,包括其地理空间分布,并将这种模式与癌症病因和发病率的历史及当代模式进行比较。对科布研究实验室中1931年至1969年间被确定死于特定癌症的个体的现有临床、人口统计学和解剖学记录进行了系统评估。将这些记录与个体死亡时的历史时期全国癌症概况以及当代癌症死亡模式进行了比较。使用商业地理信息系统对他们死亡前的居住地址进行了分析评估。为每个地点分配了一个地理空间位置,并调查了每个地点与地点集群之间的距离。1931年至1969年间,在科布收藏的28名个体中发现了17种不同的癌症类型。频率最高的癌症类型是胃癌、肺癌、食管癌、喉癌和支气管癌。所有癌症病例中有84%发生在男性身上,76%发生在被确定为美国非裔的个体中。发病率最高的癌症中有71%发生在美国非裔男性中。在食管癌的重新分布中最明显地观察到了地理空间聚集现象。我们的研究结果为我们了解1931年至1969年间华盛顿特区美国非裔中常见的癌症发病原因提供了历史深度。我们将这些发现与关于癌症病因和发病率种族差异的全国历史数据进行了对比。我们的研究表明,历史数据可以为我们理解弱势群体中癌症易感性的持续性提供纵向深度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7215/6243064/1f648e04b0d5/fonc-08-00383-g0001.jpg

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