Division of Cancer Epidemiology, Department of Oncology, McGill University, Montréal, Canada.
Cancer Epidemiol Biomarkers Prev. 2023 Jul 5;32(7):906-918. doi: 10.1158/1055-9965.EPI-22-1191.
The Canadian Cancer Registry (CCR) does not collect demographic data beyond age and sex, making it difficult to monitor health inequalities. Using data linkage, we compared site-specific cancer incidence rates by race.
The 2006 and 2011 Canadian Census Health and Environment Cohorts are population-based probabilistically linked datasets of 5.9 million respondents of the 2006 long-form census and 6.5 million respondents of the 2011 National Household Survey. Race was self-reported. Respondent data were linked with the CCR up to 2015. We calculated age-standardized incidence rate ratios (ASIRR), comparing group-specific rates to the overall population rate with bootstrapped 95% confidence intervals (CI). We used negative binomial regressions to adjust for socioeconomic variables and assess interactions with immigration status.
The age-standardized overall cancer incidence rate was lower in almost all non-White racial groups than in the overall population, except for White and Indigenous peoples who had higher incidence rates than the overall population (ASIRRs, 1.03-1.04). Immigrants had substantially lower age-standardized overall cancer incidence rates than nonimmigrants (ASIRR, 0.83; 95% CI, 0.82-0.84). Stomach, liver, and thyroid cancers and multiple myelomas were the sites where non-White racial groups had consistently higher site-specific cancer incidence rates than the overall population. Immigration status was an important modifier of cancer risk in the interaction model.
Differences in cancer incidence between racial groups are likely influenced by differences in lifestyles, early life exposures, and selection factors for immigration.
Data linkage can help monitor health inequalities and assess progress in preventive interventions against cancer. See related commentary by Withrow and Gomez, p. 876.
加拿大癌症登记处（CCR）不收集年龄和性别以外的人口统计学数据，因此难以监测健康不平等问题。我们通过数据链接，比较了按种族划分的特定部位癌症发病率。
2006 年和 2011 年加拿大人口普查健康与环境队列是基于人群的概率链接数据集，包含 590 万 2006 年长式普查和 650 万 2011 年全国住户调查的受访者。种族是自我报告的。受访者数据与 CCR 链接至 2015 年。我们计算了年龄标准化发病率比（ASIRR），将特定组的比率与总体人口比率进行比较，置信区间（CI）为 95%的 bootstrap。我们使用负二项回归来调整社会经济变量，并评估与移民身份的相互作用。
除了白人原住民群体的发病率高于总人口外，几乎所有非白人种族群体的年龄标准化总体癌症发病率都低于总人口（ASIRR，1.03-1.04）。移民的年龄标准化总体癌症发病率明显低于非移民（ASIRR，0.83；95%CI，0.82-0.84）。胃癌、肝癌、甲状腺癌和多发性骨髓瘤是白人原住民群体的特定部位癌症发病率始终高于总人口的部位。在交互模型中，移民身份是癌症风险的重要调节因素。
不同种族群体之间癌症发病率的差异可能受到生活方式、早期生活暴露和移民选择因素的影响。
数据链接可以帮助监测健康不平等，并评估预防癌症干预措施的进展。请参阅 Withrow 和 Gomez 的相关评论，第 876 页。
