Socioeconomic and Racial/Ethnic Disparities in Cancer Mortality, Incidence, and Survival in the United States, 1950-2014: Over Six Decades of Changing Patterns and Widening Inequalities.
Socioeconomic and Racial/Ethnic Disparities in Cancer Mortality, Incidence, and Survival in the United States, 1950-2014: Over Six Decades of Changing Patterns and Widening Inequalities.
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DOI：
10.1155/2017/2819372
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发表时间：
2017
影响因子：
--
通讯作者：
Jemal A
中科院分区：
文献类型：
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作者：
Singh GK;Jemal A
我们分析了1950年至2014年美国所有癌症和主要癌症的死亡率、发病率和生存率的社会经济和种族/民族差异。以人口普查为基础的剥夺指数与国家死亡率和癌症数据有关，以区域为基础的死亡率、发病率和生存率的社会经济模式。国家纵向死亡率研究用于分析个人层面的社会经济和种族/民族死亡率模式。比率、风险比、最小二乘、对数线性和Cox回归用于检验趋势和差异。随着时间的推移，所有癌症、肺癌和结直肠癌死亡率的社会经济模式发生了巨大变化。生活在较贫困地区或教育程度较低、收入较低群体的人，其死亡率和发病率高于富裕人群，尤其是肺癌、结直肠癌、宫颈癌、胃癌和肝癌的风险过高。1979-2011年期间，所有癌症、肺癌、前列腺癌和宫颈癌死亡率的教育和收入不平等有所加剧。由于低社会经济群体/地区的死亡率下降较慢，癌症死亡率的社会经济不平等现象扩大。黑人的死亡率高于白人，亚洲/太平洋岛民和西班牙裔的死亡率低于白人。在更贫困的社区和大多数少数民族群体中，癌症患者的存活率明显较低。癌症死亡率和发病率的差异可能反映了吸烟、肥胖、缺乏身体活动、饮食、饮酒、筛查和治疗方面的不平等。
We analyzed socioeconomic and racial/ethnic disparities in US mortality, incidence, and survival rates from all-cancers combined and major cancers from 1950 to 2014. Census-based deprivation indices were linked to national mortality and cancer data for area-based socioeconomic patterns in mortality, incidence, and survival. The National Longitudinal Mortality Study was used to analyze individual-level socioeconomic and racial/ethnic patterns in mortality. Rates, risk-ratios, least squares, log-linear, and Cox regression were used to examine trends and differentials. Socioeconomic patterns in all-cancer, lung, and colorectal cancer mortality changed dramatically over time. Individuals in more deprived areas or lower education and income groups had higher mortality and incidence rates than their more affluent counterparts, with excess risk being particularly marked for lung, colorectal, cervical, stomach, and liver cancer. Education and income inequalities in mortality from all-cancers, lung, prostate, and cervical cancer increased during 1979–2011. Socioeconomic inequalities in cancer mortality widened as mortality in lower socioeconomic groups/areas declined more slowly. Mortality was higher among Blacks and lower among Asian/Pacific Islanders and Hispanics than Whites. Cancer patient survival was significantly lower in more deprived neighborhoods and among most ethnic-minority groups. Cancer mortality and incidence disparities may reflect inequalities in smoking, obesity, physical inactivity, diet, alcohol use, screening, and treatment.