Introduction: Lung cancer incidence is higher among non‐Hispanic (NH) blacks than among the NH white and Hispanic populations in the United States. However, national cancer estimates may not always reflect the cancer burden in terms of disparities and incidence in small geographic areas, especially urban‐rural disparities. Moreover, there is a gap in the literature regarding rural‐urban disparities in terms of cancer histologic type. Methods: Using population‐based cancer registry data—Surveillance, Epidemiology and End Results and National Program of Cancer Registries data—we present age‐adjusted histologic rates and trends by race/ethnicity and residential county location at the time of first cancer diagnosis. Rate ratios were calculated to examine racial/ethnic differences in rates. Annual percent change was calculated to measure changes in rates over time. Results: We found that declines in squamous cell carcinoma are occurring fastest in metropolitan counties, whereas rates of adenocarcinoma increased fastest in counties nonadjacent to metropolitan areas. Further, although NH black men have increased lung cancer incidence compared with NH white and Hispanic men in all geographic locations, we found that the degree of the disparity increases with increasing rurality of residence. Finally, we discovered that among women whose lung cancer was diagnosed when they were younger than 55 years, the incidence of squamous cell carcinoma and adenocarcinoma was higher for NH blacks than for NH whites. Conclusions: Our results highlight disparities among NH blacks in nonadjacent rural areas. These findings may have significant impact for the implementation of smoking cessation and lung cancer screening programs.

中文翻译：

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组织学肺癌发病率和趋势因种族/民族和居住县而异


简介：在美国，非西班牙裔 (NH) 黑人的肺癌发病率高于 NH 白人和西班牙裔人群。然而，国家癌症估计值可能并不总是反映小地理区域的癌症负担差异和发病率，特别是城乡差异。此外，关于癌症组织学类型方面的城乡差异的文献中存在差距。方法：使用基于人群的癌症登记数据（监测、流行病学和最终结果以及国家癌症登记计划数据），我们按首次癌症诊断时的种族/族裔和居住县位置呈现年龄调整的组织学发生率和趋势。计算比率以检查比率中的种族/民族差异。计算年度百分比变化来衡量利率随时间的变化。结果：我们发现，在大都市地区，鳞状细胞癌的发病率下降最快，而在不毗邻大都市地区的县，腺癌的发病率上升最快。此外，尽管在所有地理位置上，与新罕布什尔州白人和西班牙裔男性相比，新罕布什尔州黑人男性的肺癌发病率有所增加，但我们发现，随着居住农村地区的增加，这种差异程度也随之增加。最后，我们发现，在 55 岁以下被诊断出肺癌的女性中，新罕布什尔州黑人的鳞状细胞癌和腺癌的发病率高于新罕布什尔州白人。结论：我们的结果凸显了非相邻农村地区新罕布什尔州黑人之间的差异。这些发现可能对戒烟和肺癌筛查计划的实施产生重大影响。