Racial Differences in Incident Genitourinary Cancer Cases Captured in the National Cancer Database

Abstract

Background and Objectives: The National Cancer Database (NCDB) captures nearly 70% of all new cancer diagnoses in the United States, but there exists significant variation in this capture rate based on primary tumor location and other patient demographic factors. Prostate cancer has the lowest coverage rate of all major cancers, and other genitourinary malignancies likewise fall below the average NCDB case coverage rate. We aimed to explore NCDB coverage rates for patients with genitourinary cancers as a function of race. Materials and Methods: We compared the incidence of cancer cases in the NCDB with contemporary United States Cancer Statistics data. Results: Across all malignancies, American Indian/Alaskan Natives subjects demonstrated the lowest capture rates, and Asian/Pacific Islander subjects exhibited the second-lowest capture rates. Between White and Black subjects, capture rates were significantly higher for White subjects overall and for prostate cancer and kidney cancer in White males, but significantly higher for bladder cancer in Black versus White females. No significant differences were observed in coverage rates for kidney cancer in females, bladder cancer in males, penile cancer, or testicular cancer in White versus Black patients. Conclusions: Differential access to Commission on Cancer-accredited treatment facilities for racial minorities with genitourinary cancer constitutes a unique avenue for health equity research.

Comparison of Capture Rates of the National Cancer Database Across Race and Ethnicity

“…Limited literature indicates that American Indian or Alaska Native individuals have the lowest capture rates across all genitourinary cancers. 7 This finding is consistent with our findings. However, the literature does not explore these patterns for other cancer types or for Hispanic individuals and has not been updated since 2006.…”

“…The associations of Hispanic ethnicity and American Indian or Alaska Native race with NCDB capture rates have remained underexplored. Limited literature indicates that American Indian or Alaska Native individuals have the lowest capture rates across all genitourinary cancers . This finding is consistent with our findings.…”

“…This finding is consistent with our findings. However, the literature does not explore these patterns for other cancer types or for Hispanic individuals and has not been updated since 2006 . Nevertheless, the NCDB is widely used for many types of cancer research; in 2017, more than 300 articles were identified that used data from the NCDB .…”

“…Fourth, the USCS database does not provide the stage of diagnosis or demographic baseline information (eg, sex distribution and mean age) for individuals diagnosed with cancer; therefore, analyses stratifying by stage of diagnosis or other demographic variables could not be performed in this study. In the end, this study presents the most updated information regarding NCDB capture rates for various races for breast, colorectal, lung, and prostate cancer …”

“… 7 The NCDB capture rates for various racial groups are well characterized for genitourinary cancers, revealing that American Indian or Alaska Native and Asian or Pacific Islander individuals have the lowest capture rates. 7 However, it is unknown how capture rates have changed for nongenitourinary cancers among American Indian or Alaska Native individuals or for individuals who are Hispanic. Previous work 8 found that the capture rate for Hispanic individuals is 51.1%.…”