Bunin G
J Natl Cancer Inst. 1987 May;78(5):875-80.
Racial patterns of childhood brain cancer by histologic type were studied using data from the Third National Cancer Survey and the Surveillance, Epidemiology, and End Results Program. Incidence rates for whites of all types combined and of astrocytic glioma and medulloblastoma were slightly higher than those for blacks. Proportionately more black than white cases of astrocytic glioma were diagnosed between the ages of 5-9 years; this difference corresponded to twofold-higher rates at ages of 0-4 and 10-14 years and similar rates at ages of 5-9 years among whites compared to rates among nonwhites. A real difference in age-incidence curves rather than diagnostic delay among blacks appeared to explain the differences. For medulloblastoma, the male-female rate ratio differed between whites (1.7) and blacks (1.0). Time trend analyses revealed statistically significant increases in medulloblastoma and glioma not otherwise specified (NOS) for incidences among blacks. The rate of microscopic confirmation was significantly higher among whites than among blacks, a difference apparently not explained by differences in the accessibility of tumors for biopsy. For avoidance of biased comparisons, differences in rates of microscopic confirmation and time trends for glioma NOS should be considered in studies of racial patterns of childhood brain cancer incidence by histologic type.
利用第三次全国癌症调查以及监测、流行病学和最终结果计划的数据,对按组织学类型划分的儿童脑癌种族模式进行了研究。所有类型合并的白人以及星形细胞瘤和髓母细胞瘤的发病率略高于黑人。在5至9岁之间诊断出的星形细胞瘤病例中,黑人的比例比白人高;这种差异相当于白人在0至4岁和10至14岁时的发病率是黑人的两倍,而在5至9岁时白人和非白人的发病率相似。黑人年龄发病率曲线的实际差异而非诊断延迟似乎可以解释这些差异。对于髓母细胞瘤,白人和黑人的男女发病率比有所不同(白人1.7,黑人1.0)。时间趋势分析显示,黑人中髓母细胞瘤和未另作说明的胶质瘤(NOS)的发病率有统计学上的显著增加。白人的显微镜确诊率明显高于黑人,这种差异显然不能用肿瘤活检的可及性差异来解释。为避免有偏差的比较,在按组织学类型研究儿童脑癌发病率的种族模式时,应考虑胶质瘤NOS的显微镜确诊率差异和时间趋势。