McKinnish Tyler R, Kuroki Lindsay M, Schwarz Julie K, Mazul Angela L
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Washington University School of Medicine, St Louis, MO.
Department of Radiation Oncology, Washington University in St Louis School of Medicine, St Louis, MO.
J Low Genit Tract Dis. 2025 Jan 1;29(1):48-54. doi: 10.1097/LGT.0000000000000859. Epub 2024 Dec 2.
This article describe trends in the incidence and mortality of cervical (CC) and anal (AC) cancers by race and neighborhood socioeconomic status.
The Surveillance, Epidemiology, and End Results (SEER) database was used to construct a cohort of CC and AC cases from 2006 to 2018. Incidence rates and survival were calculated by race and neighborhood socioeconomic status (nSES). Annual percent change (APC) in incidence was calculated using linear regression, and 5-year overall survival (OS) by the Kaplan-Meier method.
Of the cases, 33,487 CC and 16,018 AC cases were identified. Women of low nSES were nearly 4 times more likely to be diagnosed with cervical cancer than those of high nSES. Cervical cancer incidence declined marginally in all groups except for low nSES women who are White (APC 0.0). Women who are Black had lower 5-year OS than their nSES counterparts of other races (most notably for Black women of low nSES 53% vs White 63%). Similarly, the low nSES AC cohort contained nearly 3 times the number of diagnoses as the high nSES cohort. AC incidence increased most in women who are White (APC 1.8 and 2.2 for low and high nSES) and men who are Black and low nSES (APC 3.3). Five-year OS was lowest for men who are Asian American and Pacific Islander (40% and 50% for low and high nSES, respectively).
These data suggest a strong correlation between nSES, race, and their interaction on the incidence and survival trends of HPV-related disease and highlight inconsistent effects between cervical and anal cancers.
本文描述了按种族和邻里社会经济地位划分的宫颈癌（CC）和肛门癌（AC）的发病率和死亡率趋势。
利用监测、流行病学和最终结果（SEER）数据库构建了一个2006年至2018年的CC和AC病例队列。发病率和生存率按种族和邻里社会经济地位（nSES）计算。发病率的年度百分比变化（APC）采用线性回归计算，5年总生存率（OS）采用Kaplan-Meier方法计算。
共识别出33487例CC病例和16018例AC病例。nSES低的女性被诊断为宫颈癌的可能性几乎是nSES高的女性的4倍。除了nSES低的白人女性（APC为0.0）外，所有组的宫颈癌发病率均略有下降。黑人女性的5年总生存率低于其他种族nSES相当的女性（最明显的是nSES低的黑人女性为53%，而白人女性为63%）。同样，nSES低的AC队列中的诊断病例数几乎是nSES高的队列的3倍。AC发病率在白人女性（nSES低和高的APC分别为1.8和2.2）以及nSES低的黑人男性（APC为3.3）中增加最多。亚裔美国人和太平洋岛民男性的5年总生存率最低（nSES低和高的分别为40%和50%）。
这些数据表明nSES、种族及其相互作用与HPV相关疾病的发病率和生存趋势之间存在密切关联，并突出了宫颈癌和肛门癌之间不一致的影响。
