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2002-2006 年至 2015-2019 年期间美国按种族和民族划分的 5 年癌症生存率差距趋势。

Trends in 5-year cancer survival disparities by race and ethnicity in the US between 2002-2006 and 2015-2019.

机构信息

Pancreas Center, Nanjing BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, China.

Pancreas Center, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, People's Republic of China.

出版信息

Sci Rep. 2024 Sep 30;14(1):22715. doi: 10.1038/s41598-024-73617-z.

Abstract

Racial and ethnic disparities persist in cancer survival rates across the United States, despite overall improvements. This comprehensive analysis examines trends in 5-year relative survival rates from 2002-2006 to 2015-2019 for major cancer types, elucidating differences among racial/ethnic groups to guide equitable healthcare strategies. Data from the SEER Program spanning 2000-2020 were analyzed, focusing on breast, colorectal, prostate, lung, pancreatic cancers, non-Hodgkin lymphoma, acute leukemia, and multiple myeloma. Age-standardized relative survival rates were calculated to assess racial (White, Black, American Indian/Alaska Native, Asian/Pacific Islander) and ethnic (Hispanic, Non-Hispanic) disparities, utilizing period analysis for recent estimates and excluding cases identified solely through autopsy or death certificates. While significant survival improvements were observed for most cancers, notable disparities persisted. Non-Hispanic Blacks exhibited the largest gain in breast cancer survival, with an increase of 5.2% points (from 77.6 to 82.8%); however, the survival rate remained lower than that of Non-Hispanic Whites (92.1%). Colorectal cancer survival declined overall (64.7-64.1%), marked by a 6.2% point drop for Non-Hispanic American Indian/Alaska Natives (66.3-60.1%). Prostate cancer survival declined across all races, with Non-Hispanic American Indian/Alaska Natives showing a decrease of 7.7% points (from 96.9 to 89.2%). Lung cancer, acute leukemia, and multiple myeloma showed notable increases across groups. Substantial racial/ethnic disparities in cancer survival underscore the notable need for tailored strategies ensuring equitable access to advanced treatments, particularly addressing significant trends in colorectal and pancreatic cancers among specific minority groups. Careful interpretation of statistical significance is warranted given the large dataset.

摘要

尽管美国整体癌症存活率有所提高,但在不同种族和族裔群体之间仍然存在明显差异。本综合分析检查了从 2002-2006 年至 2015-2019 年主要癌症类型的 5 年相对存活率趋势,阐明了不同种族/族裔群体之间的差异,以指导公平的医疗保健策略。该分析使用了 2000-2020 年 SEER 计划的数据,重点关注乳腺癌、结直肠癌、前列腺癌、肺癌、胰腺癌、非霍奇金淋巴瘤、急性白血病和多发性骨髓瘤。利用时期分析方法计算了年龄标准化相对存活率,以评估种族(白种人、黑种人、美国印第安人/阿拉斯加原住民、亚洲/太平洋岛民)和族裔(西班牙裔、非西班牙裔)的差异,最近的估计值不包括仅通过尸检或死亡证明确定的病例。尽管大多数癌症的生存率都有显著提高,但仍存在显著差异。非西班牙裔黑人的乳腺癌生存率提高幅度最大,增加了 5.2 个百分点(从 77.6%增加到 82.8%);然而,其生存率仍低于非西班牙裔白人(92.1%)。结直肠癌的总体生存率下降(64.7-64.1%),非西班牙裔美国印第安人/阿拉斯加原住民的生存率下降了 6.2 个百分点(从 66.3%下降到 60.1%)。所有种族的前列腺癌生存率均下降,非西班牙裔美国印第安人/阿拉斯加原住民下降了 7.7 个百分点(从 96.9%下降到 89.2%)。肺癌、急性白血病和多发性骨髓瘤在所有群体中的生存率都有显著提高。癌症生存率方面存在显著的种族/族裔差异,这突出表明需要制定有针对性的策略,确保公平获得先进治疗,特别是解决特定少数群体中结直肠癌和胰腺癌的显著趋势。鉴于数据集庞大,需要对统计显著性进行仔细解释。

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