Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA.
Department of Gastroenterology, Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA.
Clin Transl Gastroenterol. 2021 Jun 23;12(7):e00374. doi: 10.14309/ctg.0000000000000374.
Alaska Native (AN) people experience a high burden of gastric cancer compared with other US Native and non-Native populations. Previous reports have suggested that gastric cancer in AN people occurs at a younger age and is a more aggressive pathologic type. We evaluated all cases of gastric cancer in AN people from 1990 to 2017 and compared the epidemiologic and pathologic characteristics with the gastric cancers that occurred in the same time in the US white (USW) population.
Cancer data were collected by the Alaska Native Tumor Registry and National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Comparisons were performed looking at the age and sex distribution of the affected AN and USW people, as well as the cancer characteristics, including the location, stage, and pathology.
The age distribution was significantly different between AN and USW patients (P < 0.001), with a greater proportion of AN people diagnosed younger than 40 years (11% vs 3%, P < 0.0001) and 40-59 years (37% vs 20%, P < 0.0001). In addition, a greater proportion of AN people were diagnosed with distant stage cancer (AN: 48% and USW: 35%, P < 0.0001). The age-adjusted rate of gastric cancer in the AN population was significantly higher than the USW population (20.8 vs 6.7 per 100,000 persons, P < 0.0001). Although there has been a significant decrease in the gastric cancer incidence rate in the USW population, no significant change in incidence was seen in the AN population.
This study highlights the disproportionate burden of gastric cancer in the AN population. Further work is needed to address and understand this disparity.
与其他美国原住民和非原住民人群相比，阿拉斯加原住民（AN）人群的胃癌负担较高。先前的报告表明，AN 人群的胃癌发病年龄较小，且具有更具侵袭性的病理类型。我们评估了 1990 年至 2017 年期间所有 AN 人群的胃癌病例，并将其与同期美国白人（USW）人群的胃癌病例进行了比较，以评估其流行病学和病理特征。
癌症数据由阿拉斯加原住民肿瘤登记处和美国国家癌症研究所的监测、流行病学和最终结果计划收集。通过比较受影响的 AN 和 USW 人群的年龄和性别分布，以及癌症特征，包括位置、分期和病理，来进行比较。
AN 和 USW 患者的年龄分布存在显著差异（P < 0.001），AN 人群中 40 岁以下（11% vs. 3%，P < 0.0001）和 40-59 岁（37% vs. 20%，P < 0.0001）的诊断比例明显较高。此外，AN 人群中被诊断为远处转移期癌症的比例也更高（AN：48%和 USW：35%，P < 0.0001）。AN 人群的胃癌年龄调整发病率明显高于 USW 人群（20.8 比 6.7/100,000 人，P < 0.0001）。尽管 USW 人群的胃癌发病率显著下降，但 AN 人群的发病率并未出现显著变化。
本研究强调了 AN 人群中胃癌负担的不成比例。需要进一步努力来解决和理解这种差异。
