Dataset Information

Differences in Stage of Cancer at Diagnosis, Treatment, and Survival by Race and Ethnicity Among Leading Cancer Types.

ABSTRACT: Importance:Information about stage of cancer at diagnosis, use of therapy, and survival among patients from different racial/ethnic groups with 1 of the most common cancers is lacking. Objective:To assess stage of cancer at diagnosis, use of therapy, overall survival (OS), and cancer-specific survival (CSS) in patients with cancer from different racial/ethnic groups. Design, Setting, and Participants:This cohort study included 950?377 Asian, black, white, and Hispanic patients who were diagnosed with prostate, ovarian, breast, stomach, pancreatic, lung, liver, esophageal, or colorectal cancers from January 2004 to December 2010. Data were collected using the Surveillance, Epidemiology, and End Results (SEER) database, and patients were observed for more than 5 years. Data analysis was conducted in July 2018. Main Outcomes and Measures:Multivariable logistic and Cox regression were used to evaluate the differences in stage of cancer at diagnosis, treatment, and survival among patients from different racial/ethnic groups. Results:A total of 950?377 patients (499?070 [52.5%] men) were included in the study, with 681?251 white patients (71.7%; mean [SD] age, 65 [12] years), 116?015 black patients (12.2%; mean [SD] age, 62 [12] years), 65?718 Asian patients (6.9%; mean [SD] age, 63 [13] years), and 87?393 Hispanic patients (9.2%; mean [SD] age, 61 [13] years). Compared with Asian patients, black patients were more likely to have metastatic disease at diagnosis (odds ratio [OR], 1.144; 95% CI, 1.109-1.180; P?

SUBMITTER: Zhang C

PROVIDER: S-EPMC7142383 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Differences in Stage of Cancer at Diagnosis, Treatment, and Survival by Race and Ethnicity Among Leading Cancer Types.

Zhang Chenyue C Zhang Chenxing C Wang Qingliang Q Li Zhenxiang Z Lin Jiamao J Wang Haiyong H

JAMA network open 20200401 4

<h4>Importance</h4>Information about stage of cancer at diagnosis, use of therapy, and survival among patients from different racial/ethnic groups with 1 of the most common cancers is lacking.<h4>Objective</h4>To assess stage of cancer at diagnosis, use of therapy, overall survival (OS), and cancer-specific survival (CSS) in patients with cancer from different racial/ethnic groups.<h4>Design, setting, and participants</h4>This cohort study included 950 377 Asian, black, white, and Hispanic patie ...[more]

PMID: 32267515

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Project description:ImportanceAlthough US cancer survival rates have increased over time, disparities by race/ethnicity remain, including for children and adolescents.ObjectiveTo examine whether racial/ethnic disparities in childhood and adolescent cancer survival vary by cancer type according to relative survival rates (RSRs), a marker for amenability to medical intervention.Design, setting, and participantsIn a retrospective cohort study using US Surveillance, Epidemiology, and End Results data, 67?061 children and adolescents diagnosed at ages 0 to 19 years with a first primary malignant cancer from January 1, 2000, to December 31, 2016, were evaluated. Data analysis was performed from June 19 to November 3, 2019. Participants were followed up from the dates of diagnosis to cancer death or the end of the follow-up period, whichever came first.ExposuresRace/ethnicity defined as non-Hispanic white, non-Hispanic black, non-Hispanic American Indian/Alaskan Native, non-Hispanic Asian or Pacific Islander, or Hispanic (any race).Main outcomes and measuresCancer amenability was defined using 5-year RSRs for 103 cancer types. Cox proportional hazards regression was used to compute adjusted hazard ratios (aHRs) and 95% CIs for the association between race/ethnicity and cancer survival for high (>85% RSR), medium (70%-85% RSR), and low (<70% RSR) amenability categories.ResultsAmong 67?061 cancer cases, 36?064 were male (53.8%); most individuals were non-Hispanic white (35?186 [52.5%]) followed by Hispanic of any race (19?220 [28.7%]), non-Hispanic black (7100 [10.6%]), non-Hispanic Asian or Pacific Islander (4981 [7.4%]), and non-Hispanic American Indian/Alaskan Native (574 [0.9%]). Mean (SD) age at diagnosis was 9.66 (6.41) years. Compared with non-Hispanic white children and adolescents, a higher aHR of death was observed for high- than low-amenability cancers for non-Hispanic black patients (high: aHR, 1.59; 95% CI, 1.41-1.80 vs low: aHR, 1.35; 95% CI, 1.24-1.47; P?=?.002 for interaction) and Hispanic (any race) patients (high: aHR, 1.63; 95% CI, 1.50-1.78 vs low: aHR, 1.16; 95% CI, 1.08-1.25; P?<?.001 for interaction). Results for other race/ethnicities showed similar patterns but were not statistically significant.Conclusions and relevanceRacial/ethnic minority children and adolescents were observed to have a higher risk of death than non-Hispanic white children and adolescents, with more amenable cancers having larger relative survival differences. This disparity may be associated with a combination of factors, including differences in access to health care resources.

Project description:Over 80% of bias-motivated violent victimization is motivated by race or ethnicity and over 50% of bias victimization occurs in non-Hispanic Whites (NHW). Our aim was to determine the risk and health impacts of race/ethnicity-motivated violent victimization by victim race/ethnicity. We examined data from the National Crime Victimization Survey (2003-2015) to estimate violent victimization risk by victim race/ethnicity across race/ethnicity bias victimization, other types of bias victimizations, and non-bias violent victimizations. We examined incident and offender characteristics for race/ethnicity-motivated victimization by victim race/ethnicity. The risk of race/ethnicity-motivated violent victimization was greater for non-Hispanic Blacks (NHB) and Hispanics than for NHWs (incidence rate ratios [IRR] = 1.4; 95% confidence interval [CI] = [1.0, 2.0], and IRR = 1.6; 95% CI = [1.2, 2.1]). This translates into an additional 46.7 incidents per 100,000 person-years (95% CI = [1.4, 92.1]) for the NHB population and an additional 60.3 incidents per 100,000 person-years (95% CI = [20.3, 100.4]) for the Hispanic population. Violent incidents for NHB victims more frequently resulted in injury or medical care. Nearly 40% of NHB victims reported difficulties at school or work related to the incident where only 21.5% of NHWs and 11.7% of Hispanic victims reported similar problems. Roughly 37% of NHB victims identified a NHW offender and 45% of NHW victims identified a NHB offender. Hispanic victims identified NHB or NHW offenders in over 70% of incidents. Although literature suggests that NHWs account for the majority of bias victimizations, the risk of non-fatal violent victimization motivated by race/ethnicity is greater for NHBs and Hispanics. Crimes perpetrated against NHBs are likely more severe and victim/offender racial incongruity is common. Findings provide empiric evidence on race/ethnicity-related structural disadvantage with adverse health consequences.

Dataset Information

Differences in Stage of Cancer at Diagnosis, Treatment, and Survival by Race and Ethnicity Among Leading Cancer Types.

Publications

Differences in Stage of Cancer at Diagnosis, Treatment, and Survival by Race and Ethnicity Among Leading Cancer Types.

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