Racial/ethnic differences in colorectal cancer risk: the multiethnic cohort study.
Racial/ethnic differences in colorectal cancer risk: the multiethnic cohort study.
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DOI：
10.1002/ijc.25822
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发表时间：
2011-10-15
影响因子：
6.4
通讯作者：
Kolonel, Laurence N.
中科院分区：
文献类型：
--
作者：
Ollberding, Nicholas J.;Nomura, Abraham M. Y.;Wilkens, Lynne R.;Henderson, Brian E.;Kolonel, Laurence N.
美国结直肠癌的发病率存在明显的种族/民族差异。我们在参与多种族队列研究的 165,711 名非裔美国人、日裔美国人、拉丁裔、夏威夷原住民和白人中，研究了风险因素的种族差异在多大程度上可以解释结直肠癌总体风险和诊断时分期的年龄调整风险差异。在 10.7 年的中位随访期内，通过夏威夷和加利福尼亚州的 SEER 肿瘤登记链接发现了 2,564 例结直肠癌病例。使用多变量调整的 Cox 比例风险模型来估计每个种族与白人相比的相对风险 (RR) 和 95% 置信区间 (CI)。考虑到已知/可疑的危险因素后，与白人相比，日裔美国人（男性，RR = 1.27，95% CI = 1.09-1.48；女性，RR = 1.49，95% CI = 1.24-1.78）和非裔美国女性（RR = 1.48，95% CI = 1.23-1.79）患结直肠癌的风险仍然较高；与白人相比，非洲裔美国女性和日裔美国女性患晚期疾病的风险也更高。在针对具体地点的分析中，经过多变量调整后，与白人相比，非裔美国人（男女）和日裔美国女性患结肠癌的风险仍然较高，日裔美国人（男女）和夏威夷原住民男性患直肠癌的风险仍然较高。这项研究的结果表明，已知/疑似危险因素的分布差异仅占结直肠癌风险种族差异的一小部分，其他因素（可能包括遗传易感性）是造成观察到的发病率差异的重要因素。
Incidence rates in the U.S. show clear racial/ethnic disparities for colorectal cancer. We examined the extent to which ethnic differences in risk factors could explain the age-adjusted variation in the risk of colorectal cancer, overall and by stage at diagnosis, among 165,711 African Americans, Japanese Americans, Latinos, Native Hawaiians, and whites participating in the Multiethnic Cohort Study. Over a median follow-up period of 10.7 years, 2,564 incident cases of colorectal cancer were identified through SEER tumor registry linkages in Hawaii and California. Multivariable-adjusted Cox proportional hazard models were used to estimate relative risks (RR) and 95% confidence intervals (CI) for each ethnic group compared to whites. After accounting for known/suspected risk factors, Japanese Americans (men, RR = 1.27, 95% CI = 1.09-1.48; women, RR = 1.49, 95% CI = 1.24-1.78) and African American women (RR = 1.48, 95% CI = 1.23-1.79) remained at increased risk of colorectal cancer relative to whites; African American and Japanese American women were also at increased risk of advanced disease compared to whites. In site-specific analyses, after multivariable adjustment, African Americans (both sexes) and Japanese American women remained at increased risk for colon cancer, and Japanese Americans (both sexes) and Native Hawaiian men for rectal cancer compared to whites. The results of this study suggest that differences in the distribution of known/suspected risk factors account for only a modest proportion of the ethnic variation in colorectal cancer risk and that other factors, possibly including genetic susceptibility, are important contributors to the observed disparities in incidence.
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通讯作者：
Li, CI
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