Principal Scientist, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA.
Senior Associate Scientist, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA.
CA Cancer J Clin. 2019 May;69(3):211-233. doi: 10.3322/caac.21555. Epub 2019 Feb 14.
In the United States, African American/black individuals bear a disproportionate share of the cancer burden, having the highest death rate and the lowest survival rate of any racial or ethnic group for most cancers. To monitor progress in reducing these inequalities, every 3 years the American Cancer Society provides the estimated number of new cancer cases and deaths for blacks in the United States and the most recent data on cancer incidence, mortality, survival, screening, and risk factors using data from the National Cancer Institute, the North American Association of Central Cancer Registries, and the National Center for Health Statistics. In 2019, approximately 202,260 new cases of cancer and 73,030 cancer deaths are expected to occur among blacks in the United States. During 2006 through 2015, the overall cancer incidence rate decreased faster in black men than in white men (2.4% vs 1.7% per year), largely due to the more rapid decline in lung cancer. In contrast, the overall cancer incidence rate was stable in black women (compared with a slight increase in white women), reflecting increasing rates for cancers of the breast, uterine corpus, and pancreas juxtaposed with declining trends for cancers of the lung and colorectum. Overall cancer death rates declined faster in blacks than whites among both males (2.6% vs 1.6% per year) and females (1.5% vs 1.3% per year), largely driven by greater declines for cancers of the lung, colorectum, and prostate. Consequently, the excess risk of overall cancer death in blacks compared with whites dropped from 47% in 1990 to 19% in 2016 in men and from 19% in 1990 to 13% in 2016 in women. Moreover, the black-white cancer disparity has been nearly eliminated in men <50 years and women ≥70 years. Twenty-five years of continuous declines in the cancer death rate among black individuals translates to more than 462,000 fewer cancer deaths. Continued progress in reducing disparities will require expanding access to high-quality prevention, early detection, and treatment for all Americans.
在美国，非裔/黑人承担了不成比例的癌症负担，他们在大多数癌症中的死亡率最高，生存率最低，超过任何其他种族或族裔群体。为了监测减少这些不平等现象的进展，美国癌症协会每三年提供美国黑人的新癌症病例和死亡人数估计数，以及癌症发病率、死亡率、生存率、筛查和风险因素的最新数据，这些数据来自美国国立癌症研究所、北美癌症登记协会和国家卫生统计中心。2019 年，预计美国黑人中约有 202,260 例新癌症病例和 73,030 例癌症死亡。在 2006 年至 2015 年期间，黑人男性的总体癌症发病率下降速度快于白人男性（每年 2.4%比 1.7%），这主要归因于肺癌的下降更为迅速。相比之下，黑人女性的总体癌症发病率保持稳定（而白人女性略有上升），这反映出乳腺癌、子宫体癌和胰腺癌的发病率上升，同时肺癌和结直肠癌的发病率下降。男性（每年 2.6%比 1.6%）和女性（每年 1.5%比 1.3%）中，黑人的总体癌症死亡率下降速度均快于白人，这主要是由于肺癌、结直肠癌和前列腺癌的死亡率下降幅度更大。因此，1990 年黑人与白人相比，整体癌症死亡的超额风险从男性的 47%降至 2016 年的 19%，从女性的 19%降至 2016 年的 13%。此外，50 岁以下男性和 70 岁及以上女性的黑人和白人之间的癌症差异几乎消除。黑人癌症死亡率连续 25 年下降，意味着癌症死亡人数减少了 462,000 多人。要想继续取得减少不平等现象的进展，就需要扩大所有美国人获得高质量的预防、早期发现和治疗的机会。
