Spatial Patterns of Localized-Stage Prostate Cancer Incidence Among White and Black Men in the Southeastern United States, 1999-2001
Spatial Patterns of Localized-Stage Prostate Cancer Incidence Among White and Black Men in the Southeastern United States, 1999-2001
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DOI：
10.1158/1055-9965.epi-09-1310
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发表时间：
2010-06-01
影响因子：
3.8
通讯作者：
Oliver, M. Norman
中科院分区：
文献类型：
--
作者：
Altekruse, Sean F.;Huang, Lan;Oliver, M. Norman
背景：在美国，黑人前列腺癌发病率高于白人男性，黑人被诊断为晚期癌症的比例更高。方法：获得了占美国黑人20%的四个州的66,468例前列腺癌发病率(1999-2001年)和人口普查数据：佐治亚州、佛罗里达州、阿拉巴马州和田纳西州。通过空间扫描检测局部分期前列腺癌发病率的空间聚集性。结果：黑人前列腺癌总体发病率高于白人男性，黑人被诊断为局部性癌症的比例低于白人男性。城市居住地与局部性癌症的高相对风险之间有很强的相关性。最高的相对风险通常发生在黑人人口比例低于全国平均水平的集群中。相反，在8个地方性疾病相对风险显著升高的非城市聚集区中，有7个聚集区的黑人比例高于全国平均水平。此外，在阿拉巴马州和乔治亚州，黑人人口百分比与局部性癌症的相对风险呈正相关。结论：在按黑人人口百分比分层后，城市居民与局部性疾病(预后良好)的高相对风险之间的关联仍然存在。出乎意料的是，在局部疾病相对风险较高的8个非城市集群中，有7个集群的黑人比例高于美国人口。影响：尽管有证据表明前列腺癌存在种族差异，但也有一些令人鼓舞的发现。建议对可能对这些发现做出贡献的社区层面的因素进行研究。癌症流行病学生物标记物；19(6)；1460-7。(C)2010年AACR。
Background: In the United States, prostate cancer incidence is higher among black than among white males, with a higher proportion of blacks diagnosed with advanced-stage cancer.Methods: Prostate cancer incidence (1999-2001) and census tract data were obtained for 66,468 cases in four states that account for 20% of U.S. blacks: Georgia, Florida, Alabama, and Tennessee. Spatial clusters of localized-stage prostate cancer incidence were detected by spatial scan. Clusters were examined by relative risk, population density, and socioeconomic and racial attributes.Results: Overall prostate cancer incidence rates were higher in black than in white men, and a lower proportion of black cases were diagnosed with localized-stage cancer. Strong associations were seen between urban residence and high relative risk of localized-stage cancer. The highest relative risks generally occurred in clusters with a lower percent black population than the national average. Conversely, of eight nonurban clusters with significantly elevated relative risk of localized-disease, seven had a higher proportion of blacks than the national average. Furthermore, positive correlations between percent black population and relative risk of localized-stage cancer were seen in Alabama and Georgia.Conclusion: Association between urban residence and high relative risk of localized-stage disease (favorable prognosis) persisted after spatial clusters were stratified by percent black population. Unexpectedly, seven of eight nonurban clusters with high relative risk of localized-stage disease had a higher percentage of blacks than the U. S. population.Impact: Although evidence of racial disparity in prostate cancer was found, there were some encouraging findings. Studies of community-level factors that might contribute to these findings are recommended. Cancer Epidemiol Biomarkers Prev; 19( 6); 1460-7. (C) 2010 AACR.