Colorectal Cancer in African Americans: An Update.
Colorectal Cancer in African Americans: An Update.
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DOI：
10.1038/ctg.2016.36
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发表时间：
2016-07-28
影响因子：
3.6
通讯作者：
Hamilton F
中科院分区：
文献类型：
--
作者：
Williams R;White P;Nieto J;Vieira D;Francois F;Hamilton F
这篇综述是美国胃肠病学会(ACG)少数民族事务和文化多样性委员会2005年发表的关于非裔美国人结直肠癌(CRC)的论文的最新版本。在过去的10年里，美国结直肠癌的发病率和死亡率稳步下降。然而，与所有其他种族群体相比，非洲裔美国人的死亡率仍然是最高的，存活率却是最低的，他们的死亡率下降得惊人地慢得多。造成健康差距的原因是多方面的，包括医生和患者之间的障碍。造成差异的患者因素包括对结直肠癌筛查好处的了解不足、获得医疗保健的机会有限、保险状况以及恐惧和焦虑。医生的因素包括缺乏对筛查指南的了解以及不同的筛查建议。早期筛查被认为是减少观察到的差异的有效策略；目前，ACG和美国胃肠内窥镜医师学会建议在非裔美国人中从45岁开始进行结直肠癌筛查。尽管在所有种族和族裔群体中，儿童权利委员会的死亡人数有所下降，但非洲裔美国人中的儿童权利委员会仍有很大的负担，因此有必要采取其他战略，包括对卫生保健提供者和患者进行教育宣传，以及利用强调筛查重要性的患者导航系统。这些战略已在地方社区和全州试行，显着减少了观察到的差距。
This review is an update to the American College of Gastroenterology (ACG) Committee on Minority Affairs and Cultural Diversity's paper on colorectal cancer (CRC) in African Americans published in 2005. Over the past 10 years, the incidence and mortality rates of CRC in the United States has steadily declined. However, reductions have been strikingly much slower among African Americans who continue to have the highest rate of mortality and lowest survival when compared with all other racial groups. The reasons for the health disparities are multifactorial and encompass physician and patient barriers. Patient factors that contribute to disparities include poor knowledge of benefits of CRC screening, limited access to health care, insurance status along with fear and anxiety. Physician factors include lack of knowledge of screening guidelines along with disparate recommendations for screening. Earlier screening has been recommended as an effective strategy to decrease observed disparities; currently the ACG and American Society of Gastrointestinal Endoscopists recommend CRC screening in African Americans to begin at age 45. Despite the decline in CRC deaths in all racial and ethnic groups, there still exists a significant burden of CRC in African Americans, thus other strategies including educational outreach for health care providers and patients and the utilization of patient navigation systems emphasizing the importance of screening are necessary. These strategies have been piloted in both local communities and Statewide resulting in notable significant decreases in observed disparities.