Impact of race in lung cancer - Analysis of temporal trends from a surveillance, epidemiology, and end results database
Impact of race in lung cancer - Analysis of temporal trends from a surveillance, epidemiology, and end results database
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DOI：
10.1378/chest.120.1.55
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发表时间：
2001-07-01
期刊：
影响因子：
9.6
通讯作者：
Kalemkerian, GP
中科院分区：
文献类型：
--
作者：
Gadgeel, SM;Severson, RK;Kalemkerian, GP
研究目的：我们分析了26年来来自社区癌症数据库的数据，以描述黑人和白色肺癌患者之间的临床病理学差异，并确定发病率和生存率的相关时间趋势。人口统计数据，阶段，组织学和存活率是在社区登记的所有患有原发性支气管癌的黑人和白色患者中获得的。基于1973年至1998年底特律大都市监测、流行病学和最终结果数据库，结果：在48，318名合格患者中，23%为黑人。从1985年到1998年，两个种族的男性肺癌发病率都有所下降，黑人男性的下降幅度更大（p < 0.0001），尽管两个种族< 50岁的男性肺癌发病率都随着时间的推移而下降，但白色男性的下降幅度更大，导致年轻男性的种族差异增加。两个种族的女性发病率的时间趋势相似。在整个研究期间，黑人的远距离疾病发病率较高。两个种族的局部阶段疾病的发病率都有所下降，尽管黑人的下降幅度更大。在研究期间，由于黑人患者明显缺乏改善，2年和5年生存率存在显著的种族差异。在多变量模型中，黑人患者相对于白色患者的相对死亡风险为1.24（p < 0.0001）对于局部期，1.14区域分期组P < 0.0001，（p = 0.045）。结论：底特律大都市肺癌的发病率和生存率存在显著的种族差异，自1973年以来，出现了一些令人不安的趋势，特别是黑人患者的总体生存率没有改善。需要进一步研究，以确定造成这些时间趋势的因素。
Study objectives: We analyzed data from a community-based cancer database over a 26-year period in order to characterize clinicopathologic differences between black and white patients with lung cancer, and to identify relevant temporal trends in incidence and survival.Design, setting, and patients: Data on demographics, stage, histology and survival were obtained on all black and white patients with primary bronchogenic carcinoma registered in the community-based metropolitan Detroit Surveillance, Epidemiology, and End Results database from 1973 to 1998,Results: Of 48,318 eligible patients, 23% were black. Lung cancer incidence rates decreased for men of both races from 1985 to 1998, with a greater decline occurring in black men (p < 0.0001), Although incidence rates declined over time for men of both races < 50 years of age, this decrease was greater in white men, resulting in an increase in the racial differential in younger men. Temporal trends in incidence rates were similar for women of both races. The incidence of distant-stage disease was higher among blacks throughout the study period. The incidence of local-stage disease decreased for both races, though this decline was greater in blacks. A significant racial difference in 2-year and 5-year survival rates developed during the study period, due to a distinct lack of improvement in black patients, In a multivariate model, the relative risks of death for black patients, relative to white patients, were 1.24 (p < 0.0001) for local stage, 1.14 (p < 0.0001) for regional stage, and 1.03 (p = 0.045) for distant stage.Conclusion: Significant racial differences exist in the incidence and survival rates for lung cancer in metropolitan Detroit, Since 1973, several disturbing trends have developed, particularly with regard to the lack of improvement in overall survival in black patients. Further study is required to determine the factors responsible for these temporal trends.