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非西班牙裔美国印第安人和阿拉斯加原住民中结直肠癌、肺癌、女性乳腺癌和宫颈癌的发病率和趋势差异,1999-2018 年。

Disparities in incidence and trends of colorectal, lung, female breast, and cervical cancers among non-Hispanic American Indian and Alaska Native people, 1999-2018.

机构信息

Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 500 Gold Ave SW, 9th Floor, Suite 9222, Albuquerque, New Mexico 87102, USA.

University of Chicago, Chicago, IL, USA.

出版信息

Cancer Causes Control. 2023 Aug;34(8):657-670. doi: 10.1007/s10552-023-01705-y. Epub 2023 May 1.

Abstract

PURPOSE

This study is the first to comprehensively describe incidence rates and trends of screening-amenable cancers (colorectal, lung, female breast, and cervical) among non-Hispanic AI/AN (NH-AI/AN) people.

METHODS

Using the United States Cancer Statistics AI/AN Incidence Analytic Database, we, calculated incidence rates for colorectal, lung, female breast, and cervical cancers for NH-AI/AN and non-Hispanic White (NHW) people for the years 2014-2018 combined. We calculated age-adjusted incidence rates (per 100,000), total percent change in incidence rates between 1999 and 2018, and trends over this time-period using Joinpoint analysis. Screening prevalence by region was calculated using Behavioral Risk Factor Surveillance System data.

RESULTS

Rates of screening-amenable cancers among NH-AI/AN people varied by geographic region and age at diagnosis. Over half of all lung and colorectal cancers in NH-AI/AN people were diagnosed at later stages. Rates of lung and colorectal cancers decreased significantly between 1999-2018 among NH-AI/AN men, but no significant changes were observed in rates of screening-amenable cancers among NH-AI/AN women.

CONCLUSION

This study highlights disparities in screening-amenable cancers between NH-AI/AN and NHW people. Culturally informed, community-based interventions that increase access to preventive health services could reduce cancer disparities among AI/AN people.

摘要

目的

本研究首次全面描述了非西班牙裔美国原住民(NH-AI/AN)人群中可筛查癌症(结直肠癌、肺癌、女性乳腺癌和宫颈癌)的发病率和趋势。

方法

我们使用美国癌症统计 AI/AN 发病率分析数据库,计算了 2014 年至 2018 年期间 NH-AI/AN 和非西班牙裔白人(NHW)人群中结直肠癌、肺癌、女性乳腺癌和宫颈癌的发病率。我们计算了年龄调整后的发病率(每 10 万人)、1999 年至 2018 年间发病率总变化百分比以及此期间使用 Joinpoint 分析的趋势。使用行为风险因素监测系统数据计算了各地区的筛查流行率。

结果

NH-AI/AN 人群中可筛查癌症的发病率因地理位置和诊断时的年龄而异。超过一半的 NH-AI/AN 人群的肺癌和结直肠癌在较晚的阶段被诊断出来。NH-AI/AN 男性的肺癌和结直肠癌发病率在 1999 年至 2018 年间显著下降,但 NH-AI/AN 女性的可筛查癌症发病率没有显著变化。

结论

本研究强调了 NH-AI/AN 和 NHW 人群之间可筛查癌症的差异。基于文化的、以社区为基础的干预措施可以增加获得预防保健服务的机会,从而减少 AI/AN 人群中的癌症差异。

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