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结直肠癌:重点关注影响种族/民族差异的因素。

Colorectal Cancer: An Emphasis on Factors Influencing Racial/Ethnic Disparities.

机构信息

Department of Pediatrics and Women's Health, Texas College of Osteopathic Medicine, University of North Texas Health Science Center at Fort Worth, Fort Worth, Texas 76107.

Department of Pediatrics and Women's Health, Texas College of Osteopathic Medicine, University of North Texas Health Science Center at Fort Worth, Fort Worth, Texas 76107; Department of Anatomy and Physiology, Graduate School of Biomedical Sciences, University of North Texas Health Science Center at Fort Worth, Fort Worth, Texas 76107.

出版信息

Crit Rev Oncog. 2020;25(2):151-160. doi: 10.1615/CritRevOncog.2020035174.

Abstract

Current statistics related to cancer incidence and cancer-related death rates clearly show that specific racial/ethnic minorities are more likely to be diagnosed and/or die with cancer. Colorectal cancer (CRC) is one of the leading causes of cancer deaths in the United States and it disproportionately affects the non-Hispanic Black or African American (AA) population. When compared to the non-Hispanic White (nHW) population, incidence and death rates in AAs are 28% and 60% higher, respectively. Hispanics have an overall lower CRC incidence rate than nHWs (Hispanics: 35.5 per 100,000 population; nHWs: 40.2 per 100,000 population), but their incidence continues to rise, unlike nHWs, who are experiencing a decline. This disparity between Hispanics and nHWs is further highlighted in the younger Hispanic population. While the cause of the disparities is associated with CRC-related genetic and environmental factors, the role of specific genes/mutations in each population are still not fully unraveled. However, because CRC is a slowly progressing disease, routine screening and/or early intervention are key to achieving better outcomes in CRC patients and ultimately in closing the disparity gap among different populations. This review discusses the major factors influencing the disparities in CRC and also focuses on factors such as treatment response, family history, and screening that potentially contribute to the racial/ethnic disparities in CRC.

摘要

目前与癌症发病率和癌症相关死亡率相关的统计数据清楚地表明,特定的少数族裔/少数民族更有可能被诊断出患有癌症和/或死于癌症。结直肠癌(CRC)是美国癌症死亡的主要原因之一,它不成比例地影响非西班牙裔黑人或非裔美国人(AA)人群。与非西班牙裔白人(nHW)人群相比,AA 人群的发病率和死亡率分别高出 28%和 60%。与 nHW 人群相比,西班牙裔人群的总体 CRC 发病率较低(西班牙裔人群:每 10 万人中有 35.5 例;nHW 人群:每 10 万人中有 40.2 例),但发病率仍在上升,而 nHW 人群的发病率则在下降。这种西班牙裔人群与 nHW 人群之间的差异在年轻的西班牙裔人群中更为明显。尽管这种差异与 CRC 相关的遗传和环境因素有关,但特定基因/突变在每个群体中的作用仍未完全阐明。然而,由于 CRC 是一种进展缓慢的疾病,常规筛查和/或早期干预是实现 CRC 患者更好结果的关键,最终可以缩小不同人群之间的差异差距。本文综述了影响 CRC 差异的主要因素,并重点讨论了治疗反应、家族史和筛查等潜在因素,这些因素可能导致 CRC 中的种族/民族差异。

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