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 cancerspecific 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 < .001). Black and Hispanic patients were less likely to receive definitive treatment than Asian patients

5-Fluorouracil Conversion Pathway Mutations in Gastric Cancer

“…Indeed, while previously GC was believed to rely on mutations induced only by environmental factors (food and alcohol habits, smoke, BMI, and Helicobacter pylori), recently it was better understood the predominant role of the genetic compartment, as demonstrated by the genetic and molecular discordances between different race/ethnicities [ 37 ] or sex (i.e., the signet cell ring carcinoma—[ 38 ]). Moreover, to date, being well-known the discordances between Asian and Caucasian populations’ prognosis in GC [ 37 , 39 ], it is now clear that the genetic component exerts a fundamental action especially in this kind of cancer. To better understand the role of the 5FU conversion system mutations in GC, we analyzed all the above-described genes focusing on the mutations presented only in GC studies [ 26 , 29 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ].…”

Racial and Ethnic Differences in the Financial Consequences of Cancer-Related Employment Disruption

“…First, NH Black and Hispanic or Latinx individuals are more likely than NH White individuals to be diagnosed with advanced disease, which frequently requires more intensive and expensive treatments, and are therefore less likely to receive recommended treatments (36,37). These documented disparities in clinical outcomes likely influence the intensity and longevity of required treatment, as well as the functional limitations associated with cancer and treatment side effects.…”

Prognostic Impact of PD-L1 Expression in pN1 NSCLC: A Retrospective Single-Center Analysis

“…Differences in survival depending on patients’ ethnicity and race have been repetitively reported among various malignancies, including lung cancer [ 41 ]. For instance, the influence of heterogeneous prognostic characteristics, such as smoking status, prevalence of genomic alterations, and response to chemotherapy, were discussed on the course of the disease in a comparative study of Asian and non-Asian individuals [ 42 , 43 ].…”