Racial and Ethnic Disparities in the Incidence of Pediatric Extracranial Embryonal Tumors
Racial and Ethnic Disparities in the Incidence of Pediatric Extracranial Embryonal Tumors
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DOI：
10.1093/jnci/djx050
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发表时间：
2017-10-01
影响因子：
10.3
通讯作者：
Ribeiro, Karina
中科院分区：
文献类型：
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作者：
Friedrich, Paola;Itriago, Elena;Ribeiro, Karina
背景：很少有研究比较评估不同种族和民族的儿童癌症发病率的差异，从而为病因学研究提供信息。我们的目的是通过基于人群的癌症登记，确定美国儿童颅外胚胎肿瘤发病率的种族和民族差异。方法：从监测、流行病学和最终结果计划18(n=8188)检索2000年至2010年诊断的0-19岁儿童颅外胚胎肿瘤病例。年龄标化发病率和发病率比(IRR)按种族/民族计算。白人是参照组。结果：所有少数民族均有较低的神经母细胞瘤发病率(西班牙裔：IRR=0.53，95%可信区间[CI]=0.47~0.59；黑人：IRR=0.70，95%CI=0.61~0.81；夏威夷原住民/亚太岛民(API)：IRR=0.56，95%CI=0.46~0.67；和美洲印第安人/阿拉斯加原住民(AI/AN)：IRR=0.28，95%CI=0.15~0.48)，西班牙裔视网膜母细胞瘤发病率较高(IRR=1.26，95%CI=1.07~1.48)。西班牙裔(IRR=0.80，95%CI=0.71~0.91)和API(IRR=0.43，95%CI=0.33~0.56)的肾母细胞瘤发病率较低，而黑人的发病率与此相当。同样，在拉美裔(IRR=0.85，95%CI=0.74~0.98)和API(IRR=0.61，95%CI=0.47~0.79)中，横纹肌肉瘤的发病率较低，而黑人的发病率与此相当。然而，在黑人中，肝母细胞瘤的发病率很低(IRR=0.44，95%CI=0.28~0.68)，而西班牙裔和API的发病率相当。西班牙裔生殖细胞肿瘤发病率较高(IRR=1.30，95%CI=1.19~1.42)，黑人(IRR=0.52，95%CI=0.44~0.61)和API(IRR=0.79，95%CI=0.67~0.93)较低。结论：在美国，儿童颅外胚胎性肿瘤按种族和民族存在独特的发病模式。在这些癌症的病因中，种族/民族与遗传学、表观遗传学和基因-环境相互作用之间的相互作用值得进一步研究。
Background: Few studies have comparatively assessed differences in the incidence of childhood cancer by race and ethnicity that could inform etiologic research. We aimed to identify disparities in the incidence of pediatric extracranial embryonal tumors by race and ethnicity in the United States using a population-based cancer registry.Methods: Cases of extracranial embryonal tumors among children age 0 to 19 years diagnosed between 2000 and 2010 were retrieved from the Surveillance, Epidemiology, and End Results Program 18 (n = 8188). Age-standardized incidence rates and incidence rate ratios (IRRs) were obtained by race/ethnicity. Whites were the reference group. The percentage of families living below the poverty line by county was used to stratify by socioeconomic status (SES).Results: All minority groups had a lower incidence of neuroblastoma (Hispanics: IRR = 0.53, 95% confidence interval [CI] = 0.47 to 0.59; blacks: IRR = 0.70, 95% CI = 0.61 to 0.81; Native-Hawaiian/Asian-Pacific-Islander (API): IRR = 0.56, 95% CI = 0.46 to 0.67; and American Indian/Alaska Native (AI/AN): IRR = 0.28, 95% CI = 0.15 to 0.48) while Hispanics had a higher incidence of retinoblastoma (IRR = 1.26, 95% CI = 1.07 to 1.48). Incidence of nephroblastoma was lower among Hispanics (IRR = 0.80, 95% CI = 0.71 to 0.91) and API (IRR = 0.43, 95% CI = 0.33 to 0.56) while equivalent for blacks. Similarly, incidence of rhabdomyosarcoma was low among Hispanics (IRR = 0.85, 95% CI = 0.74 to 0.98) and API (IRR = 0.61, 95% CI = 0.47 to 0.79) while equivalent for blacks. However, incidence of hepatoblastoma was low among blacks (IRR = 0.44, 95% CI = 0.28 to 0.68) while equivalent for Hispanics and API. Incidence of germ cell tumors was higher among Hispanics (IRR = 1.30, 95% CI = 1.19 to 1.42) and lower among blacks (IRR = 0.52, 95% CI = 0.44 to 0.61) and API (IRR = 0.79, 95% CI = 0.67 to 0.93). No effect modification by SES was observed.Conclusions: Unique incidence patterns of childhood extracranial embryonal tumors exist by race and ethnicity in the United States. The interplay between race/ethnicity and genetics, epigenetics, and gene-environment interactions in the causation of these cancers deserves further investigation.