Trends in the Incidence of Colorectal Cancer in Relation to County-Level Poverty among Blacks and Whites
Trends in the Incidence of Colorectal Cancer in Relation to County-Level Poverty among Blacks and Whites
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DOI：
10.1016/s0027-9684(15)31544-3
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发表时间：
2008-12-01
影响因子：
3.3
通讯作者：
Ward, Elizabeth M.
中科院分区：
文献类型：
--
作者：
Siegel, Rebecca L.;Jemal, Ahmedin;Ward, Elizabeth M.
目的：自1998年以来，美国结直肠癌的总发病率一直在迅速下降。最近的加速下降在多大程度上因社会经济地位的不同而不同，这一点还没有得到检验。方法：利用13个监测、流行病学和最终结果报告地区的发病率数据，按种族、性别、确诊阶段和3个县贫困县(贫困县分别为10%、10%和20%)分析1992-2004年间年龄标准化结直肠癌发病率的时间趋势。结果：在白人中，低贫困和中等贫困地区男女结直肠癌发病率均有所下降。这一下降涉及男性的早期和晚期疾病以及女性的晚期疾病。与此形成对比的是，在高度贫困的人群中，男性早期疾病的发病率有所上升；晚期男性发病率稳定，男性和女性这两类疾病的发病率均保持稳定。在黑人中，发病率仅在居住在低贫困地区的男性中下降。结论：最近结直肠癌发病率的下降并未使居住在高贫困地区的人受益。需要作出更多努力，将预防和早期发现措施扩大到人口的所有部分。
Objective: The overall incidence of colorectal cancer has been decreasing rapidly in the United States since 1998. The extent to which the recent accelerated decline varies by socioeconomic status has not been examined. We analyzed trends in colorectal cancer incidence rates from 1992-2004 by area socioeconomic status, race, gender and stage at diagnosis.Methods: Incidence data from 13 Surveillance, Epidemiology and End Results reporting areas were used to examine temporal trends in age-standardized colorectal cancer incidence rates from 1992-2004 by race, gender, stage at diagnosis and 3 levels of county poverty (counties with < 10%, 10% to < 20% and >= 20% of residents living below the poverty level).Results: Among whites, colorectal cancer incidence rates decreased in both men and women residing in low- and moderate-poverty areas. The decrease involved both early- and late-stage disease in men and-late-stage disease in women. In contrast, among those residing in high-poverty are-as incidence rates increased for early-stage disease in men; rates were stable for late-stage, disease in men and for both categories of stage in women. Among blacks, incidence rates decreased only in men residing in low-poverty areas.Conclusions: The recent decrease in colorectal cancer incidence has not yet benefited persons residing in high-poverty,areas. Additional effort is needed to extend prevention and early detection measures to all segments of the population.