Going against the tide: increasing incidence of colorectal cancer among Koreans, Filipinos, and South Asians in California, 1988-2007
Going against the tide: increasing incidence of colorectal cancer among Koreans, Filipinos, and South Asians in California, 1988-2007
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DOI：
10.1007/s10552-012-9937-6
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发表时间：
2012-05-01
影响因子：
2.3
通讯作者：
Snipes, Kurt P.
中科院分区：
文献类型：
--
作者：
Giddings, Brenda Hofer;Kwong, Sandy L.;Snipes, Kurt P.
在加州，所有主要种族/族裔群体的结直肠癌发病率都显著下降，包括亚洲/太平洋岛民。分析亚洲/太平洋岛屿居民的癌症数据，掩盖了亚洲个体亚组之间存在的重要差异。本研究探讨了6个亚洲亚组（中国人、日本人、菲律宾人、韩国人、越南人和南亚人）中结直肠癌发病率的长期、性别、年龄和社会经济学特异性趋势，以确定这些群体是否经历了结直肠癌发病率的下降，并评估这些群体之间结直肠癌发病率趋势的可能差异。使用加州癌症登记数据库确定了1988年至2007年间的韩国人、越南人和南亚人。采用联合点分析法对每个亚洲亚组年龄校正结直肠癌发病率的长期、性别、年龄和社会经济学特异性趋势进行了研究，以估计年变化百分比（APC）。在男性中，韩国人（APC，3.6%）是结直肠癌发病率显著增加的唯一群体。在女性中，韩国人（APC，2.7%）、南亚人（APC，2.8%）和菲律宾人（APC，1.6%）的人数大幅增加。按诊断时年龄分层显示，50岁及以上的韩国男性（APC，3.4%）和女性（APC，2.9%）以及菲律宾女性（APC，1.8%）的结直肠癌发病率显著增加。50岁以下的韩国男性（APC，3.4%）也出现了显著增加。日本（APC，-1.2%）和中国（APC，-1.6%）50岁及以上男性结直肠癌发病率显著降低。按社会经济地位（SES）分层显示，韩国男性（APC，2.5%）和女性（APC，2.9%）以及菲律宾女性（APC，2.1%）在最低SES类别中经历了结直肠癌发病率的显著增加。韩国男性（APC，5.2%）和女性（APC，3.1%）以及菲律宾男性（APC，1.5%）在最高的SES类别中也出现了大幅增长。在最低社会经济地位类别中，日本男性（APC，-2.5%）和女性（APC，-2.0%）以及中国男性（APC，-2.8%）和女性（APC，-2.9%）出现了显著下降。中国男性在中间（APC，-3.4%）和最高（APC，-3. 5%）SES类别也经历了结直肠癌发病率的显著下降。与包括亚洲/太平洋岛民在内的所有主要种族/族裔群体中报告的结直肠癌发病率下降趋势相反，结直肠癌在加州的一些亚洲亚组中实际上正在增加，包括韩国男性和女性，以及南亚和菲律宾女性。此外，这些亚洲亚组的结直肠癌发病率趋势在诊断时的年龄和社会经济地位方面存在差异。这些发现表明，需要做出更多的努力，以针对这些人群的文化敏感的癌症预防和筛查计划。需要更多的研究来检查这些人群中结直肠癌负担的差异。
Colorectal cancer has declined markedly in California for all major racial/ethnic groups, including Asian/Pacific Islanders as a whole. Analyzing cancer data for Asian/Pacific Islanders collectively masks important differences that exist between individual Asian subgroups. This study examines secular, sex-, age-, and socioeconomic-specific trends in colorectal cancer incidence among six Asian subgroups-Chinese, Japanese, Filipino, Korean, Vietnamese, and South Asian-to determine whether these groups experienced a decline in colorectal cancer incidence and to assess possible differences in colorectal cancer incidence trends among these groups.Cases of invasive colorectal cancer diagnosed among Japanese, Chinese, Filipinos, Koreans, Vietnamese, and South Asians between 1988 and 2007 were identified using the California Cancer Registry database. Secular, sex-, age-, and socioeconomic-specific trends in the age-adjusted colorectal cancer incidence rates for each Asian subgroup were examined using joinpoint analysis to estimate the annual percent change (APC).Among males, Koreans (APC, 3.6 %) were the only group that experienced a significant increase in colorectal cancer incidence. Among females, Koreans (APC, 2.7 %), South Asians (APC, 2.8 %), and Filipinos (APC, 1.6 %) experienced significant increases. Stratification by age at diagnosis revealed that Korean males (APC, 3.4 %) and females (APC, 2.9 %) as well as Filipino females (APC, 1.8 %) aged 50 years and older experienced a significant increase in colorectal cancer incidence. Korean males aged less than 50 years (APC, 3.4 %) also experienced a significant increase. Japanese (APC, -1.2 %) and Chinese (APC, -1.6 %) males aged 50 years and older experienced a significant decrease in colorectal cancer incidence. Stratification by socioeconomic status (SES) revealed that Korean males (APC, 2.5 %) and females (APC, 2.9 %) as well as Filipino females (APC, 2.1 %) in the lowest SES category experienced a significant increase in colorectal cancer incidence. Korean males (APC, 5.2 %) and females (APC, 3.1 %) as well as Filipino males (APC, 1.5 %) in the highest SES category also experienced a significant increase. Japanese males (APC, -2.5 %) and females (APC, -2.0 %) as well as Chinese males (APC, -2.8 %) and females (APC, -2.9 %) in the lowest SES category experienced a significant decrease. Chinese males in the middle (APC, -3.4 %) and highest (APC, -3.5 %) SES categories also experienced significant decreases in colorectal cancer incidence.In contrast to the decreasing trends in colorectal cancer incidence reported among all major racial/ethnic groups including Asian/Pacific Islanders, colorectal cancer is actually increasing among some Asian subgroups in California including Korean males and females, as well as South Asian and Filipino females. Furthermore, the colorectal cancer incidence trends for these Asian subgroups differ with respect to age at diagnosis and socioeconomic status. These findings suggest that more efforts need to be made to target these populations with culturally sensitive cancer prevention and screening programs. More research is needed to examine the differences in the colorectal cancer burden among these populations.