Black and White Differences in Colorectal Cancer Screening and Screening Outcomes: A Narrative Review.
Black and White Differences in Colorectal Cancer Screening and Screening Outcomes: A Narrative Review.
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结直肠癌筛查和筛查结果的黑白差异：叙述性回顾。
DOI：
10.1158/1055-9965.epi-19-1537
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发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
Bouskill KE
中科院分区：
文献类型：
--
作者：
Rutter CM;Knudsen AB;Lin JS;Bouskill KE
结直肠癌（CRC）发病率的种族差异被广泛记录。这些差异有两个潜在的机制：获得筛查的差异，包括筛查随访，以及CRC潜在风险的差异。我们回顾了这两种机制的证据的文献。我们发现，黑人的CRC发病率高于白人，仅在筛查普及后才出现，并描述了筛查率种族差异的证据。与CRC筛查利用差异的有力证据相反，腺瘤患病率的种族差异证据有限。一般来说，接受筛查的黑人和白色患者的腺瘤患病率相似，尽管有证据表明黑人患者发生晚期腺瘤和近端结肠腺瘤的可能性高于白色患者。我们的结论是，黑人患者中较高的CRC发病率主要是由较低的CRC筛查率驱动的。我们的研究结果强调了增加黑人患者获得高质量筛查的必要性，以降低CRC的发病率和死亡率。
Racial disparities in colorectal cancer (CRC) incidence are widely documented. There are two potential mechanisms for these disparities: differences in access to screening, including screening follow-up, and differences in underlying risk of CRC. We reviewed the literature for evidence of these two mechanisms. We show that higher CRC incidence in blacks relative to whites emerged only after the dissemination of screening and describe evidence of racial disparities in screening rates. In contrast to the strong evidence for differences in CRC screening utilization, there is limited evidence for racial differences in adenoma prevalence. In general, black and white patients who are screened have similar adenoma prevalence, though there is some evidence that advanced adenomas and adenomas in the proximal colon are somewhat more likely in black than white patients. We conclude that higher rates of CRC incidence among black patients are primarily driven by lower rates of CRC screening. Our findings highlight the need to increase black patients’ access to quality screening to reduce CRC incidence and mortality.