Mills P K, Yang R
Cancer Registry of Central California, Fresno 93710, USA.
Cancer Causes Control. 1997 Sep;8(5):705-12. doi: 10.1023/a:1018423219749.
The Hmong are an ethnic minority in China, some of whom migrated to the mountainous areas of North Vietnam, Laos, and Thailand in the 19th and 20th centuries. Because of their support for the United States during the Vietnam war, many Laotian Hmong fled to Thailand and eventually were re-settled in the US after the end of that conflict. Approximately 100,000 Hmong currently live in the US, of whom about half reside in the Central Valley of California. The purpose of this study was to measure cancer incidence in this unique new immigrant population. Using the resources of the Cancer Registry of Central California (CRCC), a population-based cancer registry, cancer incidence in the Hmong was evaluated by calculating age-adjusted incidence rates as well as by calculating proportional incidence ratios. Compared with all races combined, elevated rates of cancer in the Hmong were observed for the following sites: nasopharynx, stomach, liver, pancreas, leukemia, and non-Hodgkin's lymphoma. Cervical cancer incidence overall was elevated, but more noteworthy, invasive cervix cancer rates were much higher than expected. Lower cancer rates were found for breast, prostate, and colorectal cancer. Hmong also experienced advanced stage and grade of disease at diagnosis for many cancer sites in addition to cervical cancer, which may be explained by cultural factors, including avoidance of Western medical care and low rates of participation in screening programs. This population should be followed closely and monitored for patterns of cancer incidence in the future since it provides a natural laboratory for studies of cancer etiology as this population gradually becomes acculturated to the Western lifestyle.
苗族是中国的一个少数民族，其中一些人在19世纪和20世纪迁移到越南北部、老挝和泰国的山区。由于他们在越南战争期间支持美国，许多老挝苗族逃到泰国，最终在冲突结束后被重新安置到美国。目前约有10万苗族居住在美国，其中约一半居住在加利福尼亚州的中央谷地。本研究的目的是测量这个独特的新移民群体中的癌症发病率。利用加利福尼亚州中部癌症登记处（CRCC）这一基于人群的癌症登记处的资源，通过计算年龄调整发病率以及比例发病率来评估苗族的癌症发病率。与所有种族合并计算相比，苗族在以下部位的癌症发病率升高：鼻咽癌、胃癌、肝癌、胰腺癌、白血病和非霍奇金淋巴瘤。宫颈癌总体发病率升高，但更值得注意的是，浸润性宫颈癌发病率远高于预期。乳腺癌、前列腺癌和结直肠癌的发病率较低。除宫颈癌外，苗族在许多癌症部位诊断时还经历了疾病的晚期和高分级，这可能由文化因素解释，包括避免接受西方医疗以及参与筛查项目的比例较低。由于这个群体逐渐适应西方生活方式，它为癌症病因学研究提供了一个天然实验室，因此应密切跟踪和监测该群体未来的癌症发病率模式。
