Cancer disparities in Appalachian Kentucky.
Cancer disparities in Appalachian Kentucky.
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阿巴拉契亚肯塔基州的癌症差异。
DOI：
10.1111/jrh.12763
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Vanderford,NathanL
中科院分区：
文献类型：
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作者：
Hudson,Lauren;Burus,Todd;Park,Lee;Huang,Bin;Hull,PamelaC;Vanderford,NathanL
目的癌症是美国第二大死亡原因，阿巴拉契亚肯塔基州的疾病负担增加，部分原因是健康行为和健康社会决定因素的不平等。本研究的目的是评估阿巴拉契亚肯塔基州与非阿巴拉契亚肯塔基州相比的癌症负担，以及肯塔基州与美国（不包括肯塔基州）的癌症负担。方法分析了以下数据：1968年至2018年的年度全因和全部位癌症死亡率； 2014年至2018年5年全部位和特定部位癌症发病率和死亡率； 2016 年至 2018 年美国（不包括肯塔基州）、肯塔基州、非阿巴拉契亚肯塔基州和阿巴拉契亚肯塔基州的汇总筛查和风险因素数据； 2018 年美国和肯塔基州按性别划分的人乳头瘤病毒疫苗接种率。调查结果自 1968 年以来，美国的全因死亡率和癌症死亡率大幅下降，但肯塔基州的下降幅度较小且较慢，这是由阿巴拉契亚肯塔基州内的下降幅度较小且较慢的推动的。与非阿巴拉契亚肯塔基州相比，阿巴拉契亚肯塔基州的总体癌症发病率和死亡率以及几种特定部位癌症的发病率更高。影响因素包括筛查率差异以及肥胖和吸烟率上升。结论阿巴拉契亚肯塔基州经历了持续的癌症差异，包括 50 多年来全因死亡率和癌症死亡率的上升，扩大了该地区与美国其他地区之间的差距。除了解决健康的社会决定因素外，加大力度改善健康行为和增加获得医疗保健资源的机会也有助于缩小这种差距。
PurposeCancer is the second leading cause of death in the United States, and the disease burden is elevated in Appalachian Kentucky, due in part to health behaviors and inequities in social determinants of health. This study's goal was to evaluate Appalachian Kentucky's cancer burden compared to non‐Appalachian Kentucky, and Kentucky compared to the United States (excluding Kentucky).MethodsThe following data were analyzed: annual all‐cause and all‐site cancer mortality rates from 1968 to 2018; 5‐year all‐site and site‐specific cancer incidence and mortality rates from 2014 to 2018; aggregated screening and risk factor data from 2016 to 2018 for the United States (excluding Kentucky), Kentucky, non‐Appalachian Kentucky, and Appalachian Kentucky; and human papilloma virus vaccination prevalence by sex from 2018 for the United States and Kentucky.FindingsSince 1968, the United States has experienced a large decrease in all‐cause and cancer mortality, but the reduction in Kentucky has been smaller and slower, driven by even smaller and slower reductions within Appalachian Kentucky. Appalachian Kentucky has higher overall cancer incidence and mortality rates and higher rates for several site‐specific cancers compared to non‐Appalachian Kentucky. Contributing factors include screening rate disparities and increased rates of obesity and smoking.ConclusionsAppalachian Kentucky has experienced persistent cancer disparities, including elevated all‐cause and cancer mortality rates for 50+ years, widening the gap between this region and the rest of the country. In addition to addressing social determinants of health, increased efforts aimed at improving health behaviors and increased access to health care resources could help reduce this disparity.