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美国西班牙裔/拉丁裔肺癌生存获益的假设解释。

Hypothesized Explanations for the Observed Lung Cancer Survival Benefit Among Hispanics/Latinos in the United States.

机构信息

Albert Einstein College of Medicine, Bronx, NY, USA.

New York Presbyterian Hospital-Weill Cornell Medical Center, New York, NY, USA.

出版信息

J Racial Ethn Health Disparities. 2023 Jun;10(3):1339-1348. doi: 10.1007/s40615-022-01319-1. Epub 2022 May 6.

Abstract

Hispanic/Latino ethnicity is associated with improved survival from non-small cell lung cancer compared to that for non-Hispanic Whites even though Hispanics/Latinos are more likely to potentially have inferior access-to-care and experience greater health disparities. To this end, we conducted a literature review to identify possible explanations for this survival benefit, including the role of chronic obstructive pulmonary disease and cardiovascular diseases, genetic variation, cultural influences, and immigration factors. Overall, intermittent smoking patterns, genetic variation, co-morbidities, and cultural influences were all factors likely to partially explain this survival benefit. On the other hand, immigration factors, acculturation, and access-to-care were less likely to support the survival advantage. Future research should analyze relevant Hispanic/Latino subgroups (e.g., Mexican, Puerto Rican, Cuban, Dominican, Central American, South American) and specifically focus on the relationship between Hispanic/Latino ethnicity and different lung cancer subtypes. If the Hispanic/Latino mortality benefit observed in lung cancer truly exists, a better understanding of the underlying mechanism(s) may help extend these benefits to other ethnic and racial groups.

摘要

与非西班牙裔白人相比,西班牙裔/拉丁裔的族群与非小细胞肺癌的生存改善相关,尽管西班牙裔/拉丁裔更有可能获得较差的医疗服务机会,并经历更大的健康差距。为此,我们进行了文献综述,以确定这种生存获益的可能解释,包括慢性阻塞性肺疾病和心血管疾病、遗传变异、文化影响和移民因素的作用。总的来说,间歇性吸烟模式、遗传变异、合并症和文化影响都是可能部分解释这种生存获益的因素。另一方面,移民因素、文化适应和获得医疗服务的机会不太可能支持生存优势。未来的研究应该分析相关的西班牙裔/拉丁裔亚群(例如,墨西哥裔、波多黎各裔、古巴裔、多米尼加裔、中美洲裔、南美洲裔),并特别关注西班牙裔/拉丁裔族群与不同肺癌亚型之间的关系。如果肺癌中观察到的西班牙裔/拉丁裔死亡率优势确实存在,更好地了解潜在机制可能有助于将这些益处扩展到其他族裔和种族群体。

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