Decreasing Black-White Disparities in Colorectal Cancer Incidence and Stage at Presentation in the United States.
Decreasing Black-White Disparities in Colorectal Cancer Incidence and Stage at Presentation in the United States.
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DOI：
10.1158/1055-9965.epi-16-0834
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发表时间：
2017-05
期刊：
影响因子：
--
通讯作者：
Bastani R
中科院分区：
文献类型：
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作者：
May FP;Glenn BA;Crespi CM;Ponce N;Spiegel BMR;Bastani R
在美国，结直肠癌（CRC）的发病率和结局存在长期的黑人和白人差异。诊断时的发病率和分期反映了针对CRC预防和控制的国家努力的影响。我们的目标是评估四十年来这两个指标中黑人和白人差异的趋势，以告知预防和控制工作的未来方向。我们使用监测，流行病学和最终结果（SEER）数据来识别1975年1月1日至2012年12月31日期间组织学证实的CRC白人和黑人。我们按种族和年份计算了年龄校正的发病率和晚期病例的比例。然后，我们按种族计算每个指标的年度百分比变化（APC）和平均APC，检查指标随时间的变化，并计算每年的发病率差异。1975年至2012年，共有440，144例CRC病例。白人和黑人的总发病率每年分别下降1.35%和0.46%。虽然发病率的差异从2004年到2012年有所下降（APC=-3.88%; p=0.01），但2012年黑人的发病率仍然较高。在白人和黑人中，晚期疾病每年分别下降0.27%和0.45%。2010年，白人和黑人的晚期病例比例在统计学上相似（56.60% v. 56.96%; p=0.17）。随着时间的推移，黑人和白人在CRC发病率和临床分期方面的差异有所减少。我们的研究结果反映了改善CRC差异的努力的积极影响，并强调需要采取干预措施，以进一步减少发病率差距。
There are long-standing black-white disparities in colorectal cancer (CRC) incidence and outcomes in the United States. Incidence and stage at diagnosis reflect the impact of national efforts directed at CRC prevention and control. We aimed to evaluate trends in black-white disparities in both indicators over four decades to inform the future direction of prevention and control efforts. We used Surveillance, Epidemiology, & End Results (SEER) data to identify whites and blacks with histologically confirmed CRC from January 1, 1975 through December 31, 2012. We calculated the age-adjusted incidence and the proportion of cases presenting in late stage by race and year. We then calculated the annual percentage change (APC) and average APC for each indicator by race, examined changes in indicators over time, and calculated the incidence disparity for each year. There were 440,144 CRC cases from 1975 to 2012. The overall incidence decreased by 1.35% and 0.46% per year for whites and blacks, respectively. While the disparity in incidence declined from 2004 to 2012 (APC=−3.88%; p=0.01), incidence remained higher in blacks in 2012. Late stage disease declined by 0.27% and 0.45% per year in whites and blacks, respectively. The proportion of late stage cases became statistically similar in whites and blacks in 2010 (56.60% v. 56.96%; p=0.17). Black-white disparities in CRC incidence and stage at presentation have decreased over time. Our findings reflect the positive impact of efforts to improve CRC disparities and emphasize the need for interventions to further reduce the incidence gap.