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Effectiveness of colorectal cancer screening integrating non-genetic and genetic risk: a prospective study based on UK Biobank data

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cancer Biology & Medicine 2024年第8期21卷 712-723页

作者： Yu Zhang Chao Sheng Zhangyan Lyu Hongji Dai Fangfang Song Fengju Song Yubei Huang Kexin Chen Department of Epidemiology and Biostatistics Key Laboratory of Molecular Cancer EpidemiologyKey Laboratory of Prevention and Control of Human Major DiseasesMinistry of EducationNational Clinical Research Center for CancerTianjin Medical University Cancer Institute and HospitalTianjin Medical UniversityTianjin 300060China

Objective: Few studies have evaluated the benefits of colorectal cancer(CRC) screening integrating both non-genetic and genetic risk factors. Here, we aimed to integrate an existing non-genetic risk model(Qcancer-10) and a 139-variant polygenic risk score to evaluate the effectiveness of screening on CRC incidence and ***: We applied the integrated model to calculate 10-year CRC risk for 430,908 participants in the UK Biobank, and divided the participants into low-, intermediate-, and high-risk groups. We calculated the screening-associated hazard ratios(HRs) and absolute risk reductions(ARRs) for CRC incidence and mortality according to risk ***: During a median follow-up of 11.03 years and 12.60 years, we observed 5,158 CRC cases and 1,487 CRC deaths, respectively. CRC incidence and mortality were significantly lower among screened than non-screened participants in both the intermediateand high-risk groups [incidence: HR: 0.87, 95% confidence interval(CI): 0.81±0.94;0.81, 0.73±0.90;mortality: 0.75, 0.64±0.87;0.70, 0.58±0.85], which composed approximately 60% of the study population. The ARRs(95% CI) were 0.17(0.11±0.24) and 0.43(0.24±0.61), respectively, for CRC incidence, and 0.08(0.05±0.11) and 0.24(0.15±0.33), respectively, for mortality. Screening did not significantly reduce the relative or absolute risk of CRC incidence and mortality in the low-risk group. Further analysis revealed that screening was most effective for men and individuals with distal CRC among the intermediate to high-risk ***: After integrating both genetic and non-genetic factors, our findings provided priority evidence of risk-stratified CRC screening and valuable insights for the rational allocation of health resources.

关键词： Colorectal cancer screening polygenic risk score incidence mortality

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An Outbreak of Serogroup Y Meningococcal Meningitis in a Private Secondary Vocational School-Guangzhou City,Guangdong Province,China,2023

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China CDC weekly 2024年第12期6卷 242-246,I0005页

作者： Xiang Zeng Qing He Yilan Li Yong Zhou Xiaoping Shao Pei Hu Jian Liang Yudan Song Chao Ma Lijie Zhang Limei Sun Lei Luo Chinese Field Epidemiology Training Program Chinese Center for Disease Control and PreventionBeijingChina Zhuhai Center for Disease Control and Prevention Zhuhai CityGuangdong ProvinceChina Guangdong Center for Disease Control and Prevention Guangzhou CityGuangdong ProvinceChina Guangzhou Center for Disease Control and Prevention Guangzhou CityGuangdong ProvinceChina Institute of Public Health Guangzhou Medical University&Guangzhou Center for Disease Control and PreventionGuangzhou CityGuangdong ProvinceChina Department of the National Immunization Programme Chinese Center for Disease Control and PreventionBeijingChina

What is already known about this topic?The inclusion of meningococcal vaccines in the National Immunization program(NIP)over several years has significantly reduced the incidence of meningococcal meningitis in China to historic ***,there has been a diversification of meningococcal serogroups,leading to a shift in dominant serogroups in China from serogroup A to serogroups C and B,accompanied by a rise in reports of serogroups Y and *** is added by this report?An outbreak of serogroup Y Neisseria meningitidis(Nm)in a secondary vocational school involved a single confirmed severe case and 24 individuals with laboratory-confirmed Nm *** investigation revealed that the outbreak was localized to the classroom of the confirmed *** close contact within a confined space was identified as a significant risk factor for Nm *** genotype sequence identified was type 1655(ST-1655),which is categorized under clonal complex 23(CC-23)and bears resemblance to 8 previously confirmed cases of serogroup Y meningococcal meningitis within Guangdong *** suggests that serogroup Y infections continue to sporadically emerge and have become prevalent *** are the implications for public health practice?This outbreak underscores the critical need to enhance surveillance of meningococcal serogroups and population carrier,and advocate for vaccination with MenY-containing vaccines.

关键词： break Secondary Guangdong

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Analysis of Mortality and Life Expectancy Determinants Among 5,791 Deceased Pneumoconiosis Patients — Jiangsu Province, China, 2011–2023

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China CDC weekly 2024年第52期6卷 1417-1424页

作者： Hangju Zhu Lang Zhou Jinyi Zhou Lei Han Ming Wu Department of Epidemiology School of Public HealthNanjing Medical UniversityNanjing CityJiangsu ProvinceChina The Affiliated Cancer Hospital of Nanjing Medical University Nanjing CityJiangsu ProvinceChina Department of Occupation Disease Prevention and Cure Jiangsu Provincial Center for Disease Control and PreventionNanjing CityJiangsu ProvinceChina Department of Noncommunicable Chronic Disease Control and Prevention Jiangsu Provincial Center for Disease Control and PreventionNanjing CityJiangsu ProvinceChina

Pneumoconiosis is the occupational disease with the highest proportion in *** study conducted a retrospective analysis of 5,791 deceased pneumoconiosis *** this study,males comprised 93.02%of cases,with primary affected industries being mining(58.47%),manufacturing(20.55%),and public management(16.42%).Silicosis(69.42%)and coal worker’s pneumoconiosis(20.57%)were the predominant *** patients(66.47%)were diagnosed at stage *** differences were observed in both diagnosis age and post-diagnosis survival time across disease stages(P<0.05).The proportion of patients who died directly from lung infections was the highest(37.32%).The primary underlying causes of death in pneumoconiosis patients include pulmonary infections,cardiovascular and cerebrovascular diseases,and digestive tract and lung *** expectancy for patients aged 30–35 years was 15.83 *** excluding the effects of pulmonary infections,cardiovascular diseases,digestive tract tumors,and lung tumors,life expectancy increased by 3.75,1.11,1.31,and 0.63 years,*** patients with concurrent lung tumors showed a 7.797-fold increased mortality risk,while pulmonary infections elevated mortality risk by *** strategies for pneumoconiosis should emphasize both primary disease treatment and comprehensive care for complications,particularly pulmonary infections,cardiovascular diseases,and *** integrated approach could extend survival time and enhance quality of life for affected patients.

关键词： diagnosis mortality elevated

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Prioritization of risk genes in colorectal cancer by integrative analysis of multi-omics data and gene networks

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Science China(Life Sciences) 2024年第1期67卷 132-148页

作者： Ming Zhang Xiaoyang Wang Nan Yang Xu Zhu Zequn Lu Yimin Cai Bin Li Ying Zhu Xiangpan Li Yongchang Wei Shaokai Zhang Jianbo Tian Xiaoping Miao Department of Epidemiology and Biostatistics School of Public HealthDepartment of Gastrointestinal OncologyZhongnan Hospital of Wuhan UniversityDepartment of Radiation OncologyRenmin Hospital of Wuhan UniversityTaiKang Center for Life and Medical SciencesWuhan UniversityWuhan 430071China Research Center of Public Health Renmin hospital of Wuhan UniversityWuhan UniversityWuhan 430060China Department of Cancer Epidemiology The Affiliated Cancer Hospital of Zhengzhou University&Henan Cancer HospitalHenan Engineering Research Center of Cancer Prevention and ControlHenan International Joint Laboratory of Cancer PreventionZhengzhou 450008China Department of Gastrointestinal Surgery Renmin Hospital of Wuhan UniversityWuhan 430060China Department of Radiation Oncology Renmin Hospital of Wuhan UniversityWuhan 430060China Department of Gastrointestinal Oncology Hubei Cancer Clinical Study CenterZhongnan Hospital of Wuhan UniversityWuhan 430062China Department of Epidemiology and Biostatistics School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430073China Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine Nanjing Medical UniversityNanjing 211166China

Genome-wide association studies(GWASs)have identified over 140 colorectal cancer(CRC)-associated loci;however,target genes at the majority of loci and underlying molecular mechanisms are poorly ***,we utilized a Bayesian approach,integrative risk gene selector(iRIGS),to prioritize risk genes at CRC GWAS loci by integrating multi-omics *** a result,a total of 105 high-confidence risk genes(HRGs)were identified,which exhibited strong gene dependencies for CRC and enrichment in the biological processes implicated in *** the 105 HRGs,CEBPB,located at the 20q13.13 locus,acted as a transcription factor playing critical roles in *** subsequent assays indicated the tumor promoter function of CEBPB that facilitated CRC cell proliferation by regulating multiple oncogenic pathways such as MAPK,PI3K-Akt,and Ras ***,by integrating a fine-mapping analysis and three independent case-control studies in Chinese populations consisting of 8,039 cases and 12,775 controls,we elucidated that rs1810503,a putative functional variant regulating CEBPB,was associated with CRC risk(OR=0.90,95%CI=0.86–0.93,P=1.07×10^(−7)).The association between rs1810503 and CRC risk was further validated in three additional multi-ancestry populations consisting of 24,254 cases and 58,741 ***,the rs1810503 A to T allele change weakened the enhancer activity in an allele-specific manner to decrease CEBPB expression via longrange promoter-enhancer interactions,mediated by the transcription factor,REST,and thus decreased CRC *** summary,our study provides a genetic resource and a generalizable strategy for CRC etiology investigation,and highlights the biological implications of CEBPB in CRC tumorigenesis,shedding new light on the etiology of CRC.

关键词： susceptibility genes gene screening models multi-omics GWAS CEBPB long-range promoter-enhancer interactions

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Real-world lessons: combining cancer registry and retail pharmacy data for oral cancer drugs

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Journal of the National cancer Institute - Monographs 2024年第65期2024卷 162-167页

作者： Howlader, Nadia Lund, Jennifer L. Enewold, Lindsey Stevens, Jennifer Mcneel, Timothy Rivera, Donna Mariotto, Angela Cronin, Kathleen A. Surveillance Research Program Division of Cancer Control and Population Sciences National Cancer Institute Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill Lineberger Comprehensive Cancer Center University of North Carolina at Chapel Hill Healthcare Delivery Research Program Division of Cancer Control and Population Sciences National Cancer Institute Information Management Services Oncology Center of Excellence Food and Drug Administration

Background: Recent cancer care advances have introduced new oral therapies, and yet population registries lack detailed treatment data, hampering investigations into therapy uptake, adherence, and outcomes. Objective: This study aimed to assess the representativeness and completeness of linking Surveillance, epidemiology, and End Results (SEER) cancer registry data with data from two major retail pharmacy chains, collectively covering a large segment of the US market. Methods: A deterministic data linkage between 11 SEER cancer registries and retail pharmacy data (excluding mail order fills) was conducted for individuals diagnosed with selected cancers from 2013 to 2017, with follow-up through 2019. Descriptive characteristics of the linked and unlinked populations were examined. In a selected subcohort of older women (aged ≥65) with first and only primary breast cancer who had Medicare Part D claims for tamoxifen, we further validated the linkage using Medicare Part D event data as the reference standard. Results: Among 758 068 eligible individuals, only 6.4% were linked to CVS/Walgreens data;the linkage percentage varied by age, sex, race, ethnicity, registry, and cancer type. Within the subcohort of 5963 older women with breast cancer and a claim for tamoxifen in Part D data, 25% were identified as tamoxifen users in retail pharmacy data. Out of these 1490 women, 749 (50.3%) had complete longitudinal tamoxifen dispensing information from retail pharmacy data. Conclusion: Retail pharmacy data show promise in identifying oral anticancer treatments, enhancing SEER registry efforts, but they require further validation. We propose an evaluation framework, sharing insights and potential use cases for this resource. © 2024 Published by Oxford University Press.

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Landscape analysis of environmental data sources for linkage with SEER cancer patients database

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Journal of the National cancer Institute - Monographs 2024年第65期2024卷 132-144页

作者： Tatalovich, Zaria Chtourou, Amina Zhu, Li Dellavalle, Curt Hanson, Heidi A. Henry, Kevin A. Penberthy, Lynne Surveillance Research Program Division of Cancer Control and Population Sciences National Cancer Institute Rockville MD United States Computational Sciences and Engineering Division Oak Ridge National Laboratory US Department of Energy Oakridge TN United States Temple University Philadelphia PA United States Cancer Prevention and Control Fox Chase Cancer Center Philadelphia PA United States

One of the challenges associated with understanding environmental impacts on cancer risk and outcomes is estimating potential exposures of individuals diagnosed with cancer to adverse environmental conditions over the life course. Historically, this has been partly due to the lack of reliable measures of cancer patients' potential environmental exposures before a cancer diagnosis. The emerging sources of cancer-related spatiotemporal environmental data and residential history information, coupled with novel technologies for data extraction and linkage, present an opportunity to integrate these data into the existing cancer surveillance data infrastructure, thereby facilitating more comprehensive assessment of cancer risk and outcomes. In this paper, we performed a landscape analysis of the available environmental data sources that could be linked to historical residential address information of cancer patients' records collected by the National cancer Institute's Surveillance, epidemiology, and End Results program. The objective is to enable researchers to use these data to assess potential exposures at the time of cancer initiation through the time of diagnosis and even after diagnosis. The paper addresses the challenges associated with data collection and completeness at various spatial and temporal scales, as well as opportunities and directions for future research. © 2024 The Author(s). Published by Oxford University Press. All rights reserved.

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Circulating tumor DNA as prognostic markers of relapsed breast cancer:a systematic review and meta-analysis

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Journal of the National cancer Center 2024年第1期4卷 63-73页

作者： Na’na Guo Qingxin Zhou Xiaowei Chen Baoqi Zeng Shanshan Wu Hongmei Zeng Feng Sun Hebei Province Centers for Disease Control and Prevention ShijiazhuangChina Tianjin Centers for Disease Control and Prevention TianjinChina Department of Epidemiology and Biostatistics School of Public HealthPeking UniversityBeijingChina Department of Science and Education Peking University Binhai HospitalTianjinChina Clinical Epidemiology and EBM Unit National Clinical Research Center for Digestive DiseasesBeijing Friendship HospitalCapital Medical UniversityBeijingChina National Central Cancer Registry National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Key Laboratory of Major Disease Epidemiology Ministry of Education(Peking University)BeijingChina

Objective: Circulating tumor DNA (ctDNA) is increasingly being used as a potential prognosis biomarker in patients of breast cancer. This review aims to assess the clinical value of ctDNA in outcome prediction in breast cancer patients throughout the whole treatment cycle. Methods: PubMed, Web of Science, Embase, Cochrane Library, Scopus, and clinical *** were searched from January 2016 to May 2022. Conference abstracts published in last three years were also included. The following search terms were used: ctDNA OR circulating tumor DNA AND breast cancer OR breast carcinoma. Only studies written in English languages were included. The following pre-specified criteria should be met for inclusion: (1) observational studies (prospective or retrospective), randomized control trials, case-control studies and case series studies;(2) patients with breast cancer;(3) ctDNA measurement;(4) clinical outcome data such as objective response rate (ORR), pathological complete response (pCR), relapse-free survival (RFS), overall survival (OS), and so on. The random-effect model was preferred considering the potential heterogeneity across studies. The primary outcomes included postoperative short-term outcomes (ORR and pCR) and postoperative long-term outcomes (RFS, OS, and relapse). Secondary outcomes focused on ctDNA detection rate. Results: A total of 30 studies, comprising of 19 cohort studies, 2 case-control studies and 9 case series studies were included. The baseline ctDNA was significantly negatively associated with ORR outcome (Relative Risk [RR] = 0.65, 95% confidence interval [CI]: 0.50–0.83), with lower ORR in the ctDNA-positive group than ctDNAnegative group. ctDNA during neoadjuvant therapy (NAT) treatment was significantly associated with pCR outcomes (Odds Ratio [OR] = 0.15, 95% CI: 0.04–0.54). The strong association between ctDNA and RFS or relapse outcome was significant across the whole treatment period, especially after the surgery (RFS: Hazard Ratio [HR]

关键词： ctDNA Breast cancer Prognostic outcome prediction Meta-analysis

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Global burden of thyroid cancer in 2022:Incidence and mortality estimates from GLOBOCAN

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Chinese Medical Journal 2024年第21期137卷 2567-2576页

作者： Zhangyan Lyu Yu Zhang Chao Sheng Yubei Huang Qiang Zhang Kexin Chen Department of Epidemiology and Biostatistics Key Laboratory of Molecular Cancer EpidemiologyKey Laboratory of Prevention and Control of Human Major DiseasesMinistry of EducationNational Clinical Research Center for CancerTianjin Medical University Cancer Institute and HospitalTianjin Medical UniversityTianjin 300060China Department of Maxillofacial and Otorhinolaryngology Oncology National Clinical Research Center for CancerKey Laboratory of Cancer Prevention and TherapyTianjin Medical University Cancer Institute and HospitalTianjin 300060China

Background:Thyroid cancer(TC)is the most common malignancy of the endocrine *** study aimed to assess the global distribution of TC incidence and mortality in 2022,as well as to predict the burden for the year ***:Data from the GLOBOCAN 2022 database were used to analyze the age-standardized incidence and mortality rates of TC by sex,age group(<55 years and≥55 years),country,world region,and level of Human Development Index(HDI)for 185 *** predicted incidence and mortality burden for 2050 was calculated based on demographic ***:In 2022,an estimated 821,214 new TC cases and 47,507 TC-related deaths occurred *** age-standardized incidence rates(ASIRs)and age-standardized mortality rates(ASMRs)were higher in women(ASIR:13.60 per 100,000;ASMR:0.53 per 100,000)than in men(ASIR:4.60 per 100,000;ASMR:0.35 per 100,000).The ASIR in high HDI countries was approximately ten times higher than that in low HDI countries for both sexes,with relatively similar ASMR across *** 185 countries,China had the largest number of TC cases(accounting for 56.77% of total cases)and TC-related deaths(accounting for 24.35% of global TC-related deaths),with the highest ASIR in men(13.30 per 100,000).Worldwide,approximately 64.63% of TC cases occurred in populations under 55 years old,while nearly 82.99% of TC-related deaths occurred in populations aged 55 years and *** the rates stay the same as in 2022,it is projected that approximately 1,100,000 new TC cases and 91,000 TC-related deaths will occur in 2050,indicating a 34.15% and 89.58% increase,***:TC is a highly frequent cancer worldwide with disparities across regions,genders,and age *** results provide light on the worldwide TC disease burden and facilitate regionally customized prevention measures.

关键词： Thyroid cancer Incidence Mortality Trend analysis GLOBOCAN 2022

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中国人群伤残权重测量:聚焦癌症,量化评估伤残权重对癌症疾病负担估计的影响

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Science Bulletin 2023年第13期68卷 1430-1438,M0004页

作者：雷少元郑荣寿张绍凯黄云超乔良宋冰冰贺宇彤杜灵彬王宁席云峰刘玉琴周金意张敏郑莹张永珍鞠雯魏文强 Office for Cancer Registry National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Evidence-Based Medicine Xuanwu HospitalCapital Medical UniversityBeijing 100053China Department of Cancer Epidemiology and Prevention Affiliated Cancer Hospital of Zhengzhou UniversityHenan Cancer HospitalZhengzhou 450008China Yunnan Cancer Center/Yunnan Cancer Hospital Kunming 650118China Department of Cancer Prevention and Control Sichuan Cancer Hospital&InstituteSichuan Cancer CenterSchool of MedicineUniversity of Electronic Science and Technology of ChinaChengdu 610042China Institute of Cancer Prevention and Treatment Harbin Medical University/Institute of Cancer Prevention and TreatmentHeilongjiang Academy of Medical SciencesHeilongjiang Cancer CentreHarbin 150081China Department of Cancer Prevention and Control Hebei Medical University Fourth HospitalShijiazhuang 050000China Department of Cancer Prevention Cancer Hospital of the University of Chinese Academy of Sciences/Zhejiang Cancer HospitalHangzhou 310005China Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Beijing Office for Cancer Prevention and ControlPeking University Cancer Hospital&InstituteBeijing 100142China The Inner Mongolia Autonomous Region Comprehensive Center for Disease Control and Prevention Hohhot 750306China Cancer Epidemiology Research Center Gansu Cancer HospitalLanzhou 730050China Department of Non-communicable Chronic Disease Control Jiangsu Provincial Center for Disease Control and PreventionNanjing 210009China Office of Cancer Prevention and Treatment Hubei Cancer HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430079China Department of Cancer Prevention Fudan University Shanghai Cancer CenterDepartment of OncologyShanghai Medical CollegeFudan UniversityShanghai 200032China Department of Epidemiology Shanxi

伤残权重对于量化评估非死亡相关健康损失至关重要.全球范围看,目前仅有少数国家或地区对伤残权重进行了评估,且极少有肿瘤特异性的伤残权重结果报道.本研究基于大样本人群估计中国人群肿瘤特异性伤残权重,并比较不同伤残权重对量化评... 详细信息

伤残权重对于量化评估非死亡相关健康损失至关重要.全球范围看,目前仅有少数国家或地区对伤残权重进行了评估,且极少有肿瘤特异性的伤残权重结果报道.本研究基于大样本人群估计中国人群肿瘤特异性伤残权重,并比较不同伤残权重对量化评估肿瘤疾病负担的影响.基于开放式网络调查,采用配对比较的方法进行伤残权重的测量.伤残寿命损失年(YLDs)估计为不同瘤种各时期肿瘤的患病人数与其对应时期的伤残权重乘积之和.研究共收集到44,069份有效调查问卷,估计了包含18类恶性肿瘤在内的254个健康状态的残疾权重.其中,诊断和初始治疗阶段的肿瘤特异性伤残权差异较大,脑瘤的伤残权重最高为0.619(95%不确定性区间(UI):0.606~0.632),口咽癌伤残权重最低,为0.167(95%UI:0.158~0.176).不同肿瘤伤残权重对YLDs估计影响较大,所有肿瘤合计的YLDs差异超过30%.本研究提供的肿瘤特异性伤残权重可以为精确估计肿瘤疾病负担提供重要的数据支持.

关键词： Years livedwithdisability Disabilityweights cancer Disease burden

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Pancreatic cancer survival trends in the US from 2001 to 2014:a CONCORD-3 study

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cancer Communications 2023年第1期43卷 87-99页

作者： Maja Nikšić Pamela Minicozzi Hannah K Weir Heather Zimmerman Maria J Schymura Judith R Rees Michel P Coleman Claudia Allemani 无 Cancer Survival Group Department of Non-Communicable Disease EpidemiologyLondon School of Hygiene&Tropical MedicineKeppel StreetLondon WC1E 7HTUK Centre for Health Services Studies University of KentCanterbury CT27NFUK Division of Cancer Prevention and Control Centers for Disease Control and PreventionAtlantaGA 30333USA Montana Central Tumor Registry Chronic Disease Prevention and Health Promotion BureauPO Box 2029511400 BroadwayHelenaMT 59620-2951USA Bureau of Cancer Epidemiology New York State Cancer RegistryNew York State Department of Health150 BroadwayAlbanyNY 12204-2719USA New Hampshire State Cancer Registry Norris Cotton Cancer Centerand Department of EpidemiologyGeisel School of MedicineDartmouth CollegeDartmouth-Hitchcock Medical CenterOne Medical Center DriveLebanonNH 03756USA Cancer Division University College London Hospitals NHS Foundation Trust250 Euston RoadLondon NW12PGUK US CONCORDWorking Group

Background:Survival from pancreatic cancer is low *** the US,the 5-year relative survival has been slightly higher for women,whites and younger patients than for their counterparts,and differences in age and stage at diagnosis[Corrections added Nov 16,2022,after first online publication:a new affiliation is added to Maja Nikšić]may contribute to this *** aimed to examine trends in survival by race,stage,age and sex for adults(15-99 years)diagnosed with pancreatic cancer in the ***:This population-based study included 399,427 adults registered with pancreatic cancer in 41 US state cancer registries during 2001-2014,with followup to December 31,*** estimated age-specific and age-standardized net survival at 1 and 5 ***:Overall,12.3%of patients were blacks,and 84.2%were *** 9.5%of patients were diagnosed with localized disease,but 50.5%were diagnosed at an advanced stage;slightly more among blacks,mainly among *** substantial changes were seen over time(2001-2003,2004-2008,2009-2014).In general,1-year net survival was higher in whites than in blacks(26.1%vs.22.1%during 2001-2003,35.1%vs.31.4%during 2009-2014).This difference was particularly evident among patients with localized disease(49.6%in whites vs.44.6%in blacks during 2001-2003,60.1%vs.55.3%during 2009-2014).The survival gap between blacks and whites with localized disease was persistent at 5 years after diagnosis,and it widened over time(from 24.0%vs.21.3%during 2001-2003 to 39.7%vs.31.0%during 2009-2014).The survival gap was wider among men than among ***:Gaps in 1-and 5-year survival between blacks and whites were persistent throughout 2001-2014,especially for patients diagnosed with a localized tumor,for which surgery is currently the only treatment modality with the potential for cure.

关键词： pancreatic cancer race/ethnicity stage net survival population-based cancer registries

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