The pervasive crisis of diminishing radiation therapy access for vulnerable populations in the United States, part 1: African-American patients
The pervasive crisis of diminishing radiation therapy access for vulnerable populations in the United States, part 1: African-American patients
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DOI：
10.1016/j.adro.2017.07.002
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发表时间：
2017-10-01
影响因子：
2.3
通讯作者：
Thomas, Charles R., Jr.
中科院分区：
文献类型：
--
作者：
McClelland, Shearwood, III;Page, Brandi R.;Thomas, Charles R., Jr.
简介：非洲裔美国人在美国经历了最高的癌症发病率和死亡率负担，并且一直不太可能接受介入治疗，即使这种治疗已被随机对照试验证明上级保守治疗。非裔美国人癌症患者在接受放射治疗（RT）方面存在的差异很少被广泛研究。方法和材料：使用PubMed数据库进行了广泛的文献检索，以检查调查非裔美国人接受RT方面差异的研究。结果：共发现55项研究，涵盖11个器官系统。非裔美国人接受RT的差异在乳腺癌（23项研究）、前列腺癌（7项研究）、妇科系统（5项研究）和血液系统（5项研究）中最为显著。非裔美国人接受RT的差异普遍存在，无论研究的器官系统如何，并且通常独立于社会经济地位。55项研究中有50项（91%）涉及基于人群的数据库分析，如监测、流行病学和最终结果（SEER; 26项研究），SEER-Medicare（5项研究），国家癌症数据库（3项研究）或国家肿瘤登记处结论：与白人患者相比，美国的非洲裔美国人接受RT的机会减少，独立于社会经济地位，但往往与社会经济地位低有关。这些发现强调了寻找系统性和系统性解决方案来解决这些不平等问题的重要性，以减少患者种族在接受最佳癌症护理方面提供的障碍。(C)2017作者（S）爱思唯尔公司出版
Introduction: African Americans experience the highest burden of cancer incidence and mortality in the United States and have been persistently less likely to receive interventional care, even when such care has been proven superior to conservative management by randomized controlled trials. The presence of disparities in access to radiation therapy (RT) for African American cancer patients has rarely been examined in an expansive fashion.Methods and materials: An extensive literature search was performed using the PubMed database to examine studies investigating disparities in RT access for African Americans.Results: A total of 55 studies were found, spanning 11 organ systems. Disparities in access to RT for African Americans were most prominently study in cancers of the breast (23 studies), prostate (7 studies), gynecologic system (5 studies), and hematologic system (5 studies). Disparities in RT access for African Americans were prevalent regardless of organ system studied and often occurred independently of socioeconomic status. Fifty of 55 studies (91%) involved analysis of a population-based database such as Surveillance, Epidemiology and End Result (SEER; 26 studies), SEER-Medicare (5 studies), National Cancer Database (3 studies), or a state tumor registry (13 studies).Conclusions: African Americans in the United States have diminished access to RT compared with Caucasian patients, independent of but often in concert with low socioeconomic status. These findings underscore the importance of finding systemic and systematic solutions to address these inequalities to reduce the barriers that patient race provides in receipt of optimal cancer care. (C) 2017 The Author(s). Published by Elsevier Inc.