Llanos Adana A M, Li Jie, Tsui Jennifer, Gibbons Joseph, Pawlish Karen, Nwodili Fechi, Lynch Shannon, Ragin Camille, Stroup Antoinette M
Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, United States.
Cancer Population Science, Herbert Irving Comprehensive Cancer Center, New York, NY, United States.
Front Oncol. 2022 Apr 8;12:857548. doi: 10.3389/fonc.2022.857548. eCollection 2022.
Compared to other racial and ethnic groups, little to no disaggregated cancer incidence data exist for subgroups of non-Hispanic Blacks (NHBs), despite heterogeneity in sociodemographic characteristics and cancer risk factors within this group. Our objective was to examine age-adjusted cancer incidence by nativity and birthplace among NHB cancer cases diagnosed in New Jersey.
Race, ethnicity, and birthplace data from the New Jersey State Cancer Registry were used to classify NHB cancer cases diagnosed between 2005-2017. Thirteen waves of population estimates (by county, nativity, gender, age-group) were derived from the American Community Survey using Integrated Public-Use Microdata to approximate yearly demographics. Age-adjusted cancer incidence rates (overall and by site) by birthplace were generated using SEER*Stat 8.3.8. Bivariate associations were assessed using chi-square and Fisher's exact tests. Trend analyses were performed using Joinpoint 4.7.
Birthplace was available for 62.3% of the 71,019 NHB cancer cases. Immigrants represented 12.3%, with African-born, Haitian-born, Jamaican-born, 'other-Caribbean-born', and 'other-non-American-born' accounting for 18.5%, 17.7%, 16.5%, 10.6%, and 36.8%, respectively. Overall, age-adjusted cancer incidence rates were lower for NHB immigrants for all sites combined and for several of the top five cancers, relative to American-born NHBs. Age-adjusted cancer incidence was lower among immigrant than American-born males (271.6 vs. 406.8 per 100,000) and females (191.9 vs. 299.2 per 100,000). Age-adjusted cancer incidence was lower for Jamaican-born (114.6 per 100,000) and other-Caribbean-born females (128.8 per 100,000) than African-born (139.4 per 100,000) and Haitian-born females (149.9 per 100,000). No significant differences in age-adjusted cancer incidence were observed by birthplace among NHB males. Age-adjusted cancer incidence decreased for all sites combined from 2005-2017 among American-born males, immigrant males, and American-born females, while NHB immigrant female rates remained relatively stable.
There is variation in age-adjusted cancer incidence rates across NHB subgroups, highlighting the need for more complete birthplace information in population-based registries to facilitate generating disaggregated cancer surveillance statistics by birthplace. This study fills a knowledge gap of critical importance for understanding and ultimately addressing cancer inequities.
与其他种族和族裔群体相比，尽管非西班牙裔黑人（NHB）群体的社会人口特征和癌症风险因素存在异质性，但该群体亚组的癌症发病率数据几乎没有或根本没有分类数据。我们的目的是研究新泽西州诊断出的NHB癌症病例中按出生地和出生国家划分的年龄调整癌症发病率。
使用新泽西州癌症登记处的种族、族裔和出生地数据对2005年至2017年期间诊断出的NHB癌症病例进行分类。利用综合公共使用微观数据从美国社区调查中得出13波人口估计数（按县、出生国家、性别、年龄组），以近似年度人口统计数据。使用SEER*Stat 8.3.8生成按出生地划分的年龄调整癌症发病率（总体和按部位）。使用卡方检验和费舍尔精确检验评估双变量关联。使用Joinpoint 4.7进行趋势分析。
在71,019例NHB癌症病例中，62.3%的病例有出生地信息。移民占12.3%，其中出生于非洲、海地、牙买加、“其他加勒比地区出生”和“其他非美国出生”的分别占18.5%、17.7%、16.5%、10.6%和36.8%。总体而言，与美国出生的NHB相比，NHB移民所有部位综合以及前五大癌症中几种癌症的年龄调整癌症发病率较低。移民男性的年龄调整癌症发病率低于美国出生男性（每10万人中分别为271.6例和406.8例），移民女性低于美国出生女性（每10万人中分别为191.9例和299.2例）。牙买加出生的女性（每10万人中114.6例）和其他加勒比地区出生的女性（每10万人中128.8例）的年龄调整癌症发病率低于出生于非洲的女性（每10万人中139.4例）和海地出生的女性（每10万人中149.9例）。NHB男性中按出生地观察到的年龄调整癌症发病率无显著差异。2005年至2017年期间，美国出生男性、移民男性和美国出生女性所有部位综合的年龄调整癌症发病率均下降，而NHB移民女性的发病率相对稳定。
NHB亚组的年龄调整癌症发病率存在差异，突出表明在基于人群的登记处需要更完整的出生地信息，以便按出生地生成分类癌症监测统计数据。这项研究填补了对于理解并最终解决癌症不平等问题至关重要的知识空白。
