Commentary: Health disparities across the cancer care continuum and implications for microsimulation modeling.
Commentary: Health disparities across the cancer care continuum and implications for microsimulation modeling.
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评论：整个癌症护理过程中的健康差异以及对微观模拟模型的影响。
DOI：
10.1093/jncimonographs/lgad031
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Winn,RobertA
中科院分区：
文献类型：
--
作者：
Doubeni,ChykeA;Bailey,ZinziD;Winn,RobertA
不同人群之间癌症相关生活质量或死亡率的差异是可测量的、可补救的，但却是持续存在的。健康差距的根源在于历史上的不公正，包括系统性的种族主义(1)，这反过来又造成了风险暴露、获得卫生服务和卫生服务质量方面的不平等（2-4）。在本期杂志中，癌症干预和监测建模网络（CISNET）的研究人员合作建立了人口模拟模型，以评估整个癌症护理连续体的干预措施如何导致黑人与美国总人口之间的死亡率差异（图1）。在目前监测、流行病学和最终结果项目数据中定义的种族和族裔群体中，黑人的癌症死亡率最高，亚洲和太平洋岛民最低(5)。令人鼓舞的是，从1991年到2020年，美国总体癌症死亡率下降了33%(4,5)，所有种族和族裔群体的死亡率都有所改善，各群体之间的差距也在缩小，总体而言，美国预防服务工作组（USPSTF）推荐的a级或B级筛查癌症之间的差距也在缩小（图1）(5)。然而，不同癌症部位的进展是不均匀的；肺癌的死亡率差异最大，宫颈癌的死亡率差异最小(5)。尽管如此，这些趋势是有希望的，并指出了沿着癌症护理连续体优化护理的机会（图2）。此外，通过在整个癌症治疗连续体中持续协调的努力，消除黑人和白人在结直肠癌发病率和死亡率方面的差异的证据是未来进步的强大催化剂(6)。
Cancer health disparities are measurable remediable, but persistent, differences in cancer-related quality of life or mortality across groups of people. Health disparities are rooted in historical injustices, including systemic racism (1), which, in turn, create inequities in risk exposures and access to and quality of health services (2-4).In this issue of the Journal, Cancer Intervention and Surveillance Modeling Network (CISNET) researchers collaborated on population simulation models to evaluate how interventions across the cancer care continuum contribute to mortality disparities between Black people and the overall US population (Figure 1). Across racial and ethnic groups currently defined in Surveillance, Epidemiology, and End Results Program data, Black people have the highest cancer mortality rate and the Asian and Pacific Islander group the lowest (5). Encouragingly, the overall US cancer mortality rate declined by 33% from 1991 to 2020 (4, 5), with improvements across all racial and ethnic groups along with the narrowing of the gap across groups, overall and among cancers with a Grade A or B screening recommendation from the US Preventive Services Task Force (USPSTF)(Figure 1)(5). However, the progress is heterogenous across cancer sites; mortality disparities are largest for lung and smallest for cervical cancer (5). Nonetheless, these trends are promising and point to opportunities to optimize care along the cancer care continuum (Figure 2). Further, evidence on eliminating disparities between Black and White people in both incidence and mortality for colorectal cancer using sustained, coordinated efforts across the cancer care continuum is a strong catalyst for future progress (6).
结直肠癌筛查过程中可改变的失败及其与死亡风险的关联。
影响因子：
29.4
作者：
Doubeni CA;Fedewa SA;Levin TR;Jensen CD;Saia C;Zebrowski AM;Quinn VP;Rendle KA;Zauber AG;Becerra-Culqui TA;Mehta SJ;Fletcher RH;Schottinger J;Corley DA
通讯作者：
Corley DA
影响因子：
2.6
作者：
McKenna, Claire
通讯作者：
McKenna, Claire
影响因子：
254.7
作者：
Siegel, Rebecca L.;Miller, Kimberly D.;Jemal, Ahmedin
通讯作者：
Jemal, Ahmedin