1995年至2016年美国口腔和口咽癌流行病学变化的卫生系统和政策影响

IF 5.2 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Epidemiologic Reviews Pub Date : 2017-01-01 DOI:10.1093/epirev/mxw001
Charles W LeHew, Darien J Weatherspoon, Caryn E Peterson, Abigail Goben, Karolina Reitmajer, Herve Sroussi, Linda M Kaste
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引用次数: 36

摘要

口腔癌和口咽癌通常归为“口腔癌”的总称。然而,口咽癌的发病率在美国正在增加,而口腔癌的发病率却在下降。这两种不同但合并的口腔癌是由不同的风险因素引起的。发病率和生存趋势在美国人群和解剖亚位点进行了检查。确定了不同性别、种族/民族和亚部位的发病率和生存率差异。风险因素是复杂的、相互作用的,而且不能完全确定。癌症控制研究表明,在获得护理和患者预后方面存在健康差异。数据库和补充检索产生了1995年至2016年间发表的433篇文章,这些文章描述了口腔癌流行病学与发病率、生存率、风险、差异和癌症控制有关的各个方面。口腔癌在黑人男性中的生存仍然是最棘手的负担。虽然对口腔癌病因的了解正在提高,但在政策上的应用仍然有限。癌症控制工作是多种多样的、零星的、范围有限的,而且通常缺乏成功,需要根据口腔癌/口咽癌进行分层。进一步的干预和流行病学研究、提高劳动力能力和提供综合护理被确定为公共卫生政策的重要方向。建议以烟草控制的成功为蓝本开展持续的多层次运动。
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The Health System and Policy Implications of Changing Epidemiology for Oral Cavity and Oropharyngeal Cancers in the United States From 1995 to 2016.

Oral cavity and oropharyngeal cancers are typically grouped under the general term, "oral cancer." Yet, the incidence of oropharyngeal cancers is increasing in the United States, while the incidence of oral cavity cancers has declined. These 2 distinct but conflated groups of oral cancers are attributed to different risk factors. Incidence and survival trends were examined across US population groups and by anatomical subsite. Disparities in incidence and survival by sex, race/ethnicity, and subsite were identified. Risk factors are complex, interactive, and not fully identified. Cancer control research illustrates health disparities in access to care and patient outcomes. Database and supplemental searches yielded 433 articles published between 1995 and 2016 characterizing aspects of oral cancer epidemiology relating to incidence, survival, risk, disparities, and cancer control. Oral cavity cancer survival in black men remains the most intractable burden. Although understanding of oral cancer etiology is improving, application to policy is limited. Cancer control efforts are diverse, sporadic, limited in scope, and generally lacking in success, and they need stratification by oral cavity cancers/oropharyngeal cancers. Further intervention and epidemiologic research, improved workforce capacity, and integrated care delivery are identified as important directions for public health policy. Sustained, multilevel campaigns modeled on tobacco control success are suggested.

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来源期刊
Epidemiologic Reviews
Epidemiologic Reviews 医学-公共卫生、环境卫生与职业卫生
CiteScore
8.10
自引率
0.00%
发文量
10
期刊介绍: Epidemiologic Reviews is a leading review journal in public health. Published once a year, issues collect review articles on a particular subject. Recent issues have focused on The Obesity Epidemic, Epidemiologic Research on Health Disparities, and Epidemiologic Approaches to Global Health.
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