PDF(Pubmed)
Abstract：
There are well-established disparities in colorectal cancer (CRC) outcomes between White and Black patients; however, assessments of CRC disparities for other racial/ethnic groups are limited.
The Surveillance, Epidemiology, and End Results database identified patients aged 50-74 years with CRC adenocarcinoma from 2000 to 2019. Trends in age-adjusted incidence rates were computed by stage at diagnosis and subsite across five broad race/ethnic groups (White, Black, Asian/Pacific Islander [API], American Indian/Alaskan Native [AIAN], and Hispanic) and four API subgroups (East Asian, Southeast Asian, South Asian, and Pacific Islander) Multivariable logistic regression evaluated associations between race/ethnicity and diagnosis stage. Multivariable Cox proportional hazards models assessed differences in cause-specific survival (CSS).
Hispanic, AIAN, Southeast Asian, Pacific Islander, and Black patients were 3% to 28% more likely than Whites to be diagnosed with distant stage CRC, whereas East Asian and South Asians had similar or lower risk of distant stage CRC. From Cox regression analysis, Black, AIAN, and Pacific Islanders also experienced worse CSS, while East Asian and South Asian patient groups experienced better CSS. No significant differences in CSS were observed among Hispanic, Southeast Asian, and White patients. When stratified by stage, Black patients had worse CSS across all stages (early, hazard ratio (HR) = 1.38; regional, HR = 1.22; distant, HR: 1.07, p < 0.05 for all).
Despite advances in CRC screening, treatment and early detection efforts, marked racial/ethnic disparities in incidence, stage at diagnosis, and survival persist. Findings demonstrate the extent to which aggregating heterogenous populations masks significant variability in CRC outcomes within race/ethnic subgroups.
The Surveillance, Epidemiology, and End Results database identified patients aged 50-74 years with CRC adenocarcinoma from 2000 to 2019. Trends in age-adjusted incidence rates were computed by stage at diagnosis and subsite across five broad race/ethnic groups (White, Black, Asian/Pacific Islander [API], American Indian/Alaskan Native [AIAN], and Hispanic) and four API subgroups (East Asian, Southeast Asian, South Asian, and Pacific Islander) Multivariable logistic regression evaluated associations between race/ethnicity and diagnosis stage. Multivariable Cox proportional hazards models assessed differences in cause-specific survival (CSS).
Hispanic, AIAN, Southeast Asian, Pacific Islander, and Black patients were 3% to 28% more likely than Whites to be diagnosed with distant stage CRC, whereas East Asian and South Asians had similar or lower risk of distant stage CRC. From Cox regression analysis, Black, AIAN, and Pacific Islanders also experienced worse CSS, while East Asian and South Asian patient groups experienced better CSS. No significant differences in CSS were observed among Hispanic, Southeast Asian, and White patients. When stratified by stage, Black patients had worse CSS across all stages (early, hazard ratio (HR) = 1.38; regional, HR = 1.22; distant, HR: 1.07, p < 0.05 for all).
Despite advances in CRC screening, treatment and early detection efforts, marked racial/ethnic disparities in incidence, stage at diagnosis, and survival persist. Findings demonstrate the extent to which aggregating heterogenous populations masks significant variability in CRC outcomes within race/ethnic subgroups.
摘要：
背景：白人和黑人患者在结直肠癌（CRC）结局方面存在明显差异；然而，对其他种族/族裔群体的《儿童权利公约》差异的评估有限。
方法：监测，流行病学,和最终结果数据库确定了2000年至2019年50-74岁的CRC腺癌患者。年龄调整后的发病率趋势是按诊断阶段和五个广泛的种族/族裔群体的亚中心计算的(怀特，黑色,亚洲/太平洋岛民[API]，美洲印第安人/阿拉斯加原住民[AIAN]，和西班牙裔）和四个API亚组（东亚，东南亚,南亚,和太平洋岛民）多变量逻辑回归评估了种族/种族与诊断阶段之间的关联。多变量Cox比例风险模型评估了原因特异性生存（CSS）的差异。
结果：西班牙裔，AIAN,东南亚,太平洋岛民,黑人患者比白人患者被诊断为远端CRC的可能性高3％至28％，而东亚和南亚人的远期CRC风险相似或较低.从Cox回归分析，黑色,AIAN,太平洋岛民也经历了更糟糕的CSS，而东亚和南亚患者组经历了更好的CSS。在西班牙裔之间没有观察到CSS的显着差异，东南亚,白人患者当按阶段分层时，黑人患者在所有阶段的CSS都较差(早期，危险比(HR)=1.38；区域，HR=1.22；远处，HR：1.07，全部p<0.05）。
结论：尽管CRC筛查取得了进展，治疗和早期检测工作，明显的种族/族裔差异，诊断阶段，生存持续。研究结果表明，在种族/种族亚组中，聚集的异质人群掩盖了CRC结果的显着变异性的程度。
方法：监测，流行病学,和最终结果数据库确定了2000年至2019年50-74岁的CRC腺癌患者。年龄调整后的发病率趋势是按诊断阶段和五个广泛的种族/族裔群体的亚中心计算的(怀特，黑色,亚洲/太平洋岛民[API]，美洲印第安人/阿拉斯加原住民[AIAN]，和西班牙裔）和四个API亚组（东亚，东南亚,南亚,和太平洋岛民）多变量逻辑回归评估了种族/种族与诊断阶段之间的关联。多变量Cox比例风险模型评估了原因特异性生存（CSS）的差异。
结果：西班牙裔，AIAN,东南亚,太平洋岛民,黑人患者比白人患者被诊断为远端CRC的可能性高3％至28％，而东亚和南亚人的远期CRC风险相似或较低.从Cox回归分析，黑色,AIAN,太平洋岛民也经历了更糟糕的CSS，而东亚和南亚患者组经历了更好的CSS。在西班牙裔之间没有观察到CSS的显着差异，东南亚,白人患者当按阶段分层时，黑人患者在所有阶段的CSS都较差(早期，危险比(HR)=1.38；区域，HR=1.22；远处，HR：1.07，全部p<0.05）。
结论：尽管CRC筛查取得了进展，治疗和早期检测工作，明显的种族/族裔差异，诊断阶段，生存持续。研究结果表明，在种族/种族亚组中，聚集的异质人群掩盖了CRC结果的显着变异性的程度。
