Racial Disparities and Trends in Pancreatic Cancer Incidence and Mortality in the United States

Tavakkoli, Anna; Singal, Amit G.; Waljee, Akbar K.; Elmunzer, B. Joseph; Pruitt, Sandi L.; McKey, Thomas; Rubenstein, Joel H.; Scheiman, James M.; Murphy, Caitlin C.

doi:10.1016/j.cgh.2019.05.059

Cited by 88 publications

(79 citation statements)

References 35 publications

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“…There were racial differences in the OS of young patients with PC, and the risk of death was higher in blacks. This might be due to the higher incidence of distant pancreatic cancer in black patients (Tavakkoli et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of PC in young patients is on the rise. A survey based on the SEER database found that the incidence of PC among young whites and blacks increased by 57% between 2001 and 2015 (Tavakkoli et al, 2019). In addition, another epidemiological study found that from 1992 to 2013, the annual percentage change in the incidence of PC in women aged 25-34 was more than 2.5% (Gordon-Dseagu et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Nomograms for predicting overall survival and cancer-specific survival in young patients with pancreatic cancer in the US based on the SEER database

Shi

Zhou

Yang

2020

PeerJ

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Background The incidence of young patients with pancreatic cancer (PC) is on the rise, and there is a lack of models that could effectively predict their prognosis. The purpose of this study was to construct nomograms for predicting the overall survival (OS) and cancer-specific survival (CSS) of young patients with PC. Methods PC patients younger than 50 years old from 2004 to 2015 in the Surveillance, Epidemiology, and End Results (SEER) database were selected and randomly divided into training set and validation set. Univariable and forward stepwise multivariable Cox analysis was used to determine the independent factors affecting OS. The Fine and Gray competing risk regression model was used to determine the independent factors affecting CSS. We used significant variables in the training set to construct nomograms predicting prognosis. The discrimination and calibration power of models were evaluated by concordance index (C-index), calibration curve and 10-flod cross-validation. Results A total of 4,146 patients were selected. Multivariable Cox analysis showed that gender, race, grade, pathological types, AJCC stage and surgery were independent factors affecting OS. The C-index of the nomogram predicting OS in training and validation was 0.733 (average = 0.731, 95% CI [0.724–0.738]) and 0.742 (95% CI [0.725–0.759]), respectively. Competing risk analysis showed that primary site, pathological types, AJCC stage and surgery were independent factors affecting CSS. The C-index of the nomogram predicting CSS in training and validation set was 0.792 (average = 0.765, 95% CI [0.742–0.788]) and 0.776 (95% CI [0.773–0.779]), respectively. C-index based on nomogram was better in training and validation set than that based on AJCC stage. Calibration curves showed that these nomograms could accurately predict the 1-, 3- and 5-year OS and CSS both in training set and validation set. Conclusions The nomograms could effectively predict OS and CSS in young patients with PC, which help clinicians more accurately and quantitatively judge the prognosis of individual patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Nomograms for predicting overall survival and cancer-specific survival in young patients with pancreatic cancer in the US based on the SEER database

Shi

Zhou

Yang

2020

PeerJ

View full text Add to dashboard Cite

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“…To the best of our knowledge, previous studies have not taken these features into account when evaluating the incidence and survival rates of these two cancers. Racial disparities of incidence and survival rates were well documented in several common carcinomas such as malignant meningioma, hepatocellular carcinoma, uterine corpus carcinoma, prostate carcinoma, and pancreatic carcinoma (6)(7)(8)(9)(10)(11). However, little is known about the racial disparities in the incidence and survival rates of vulvar and vaginal carcinomas.…”

Section: Introductionmentioning

confidence: 99%

Rising and Falling Trends in Incidence Rates of Vulvar and Vaginal Cancers in the United States, 2000-2016

Yue

Zhou

Pei

2020

Preprint

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Background: Few studies focus on incidence trends in vulvar and vaginal by histological type, race, age, and region. We aimed to evaluate the temporal incidence trends and survival for the two cancers.Methods: Cases with primary vulvar or vaginal carcinoma from 2000-2016 were identified from the Surveillance, Epidemiology, and End Results 18 registries. Annual percent change (APC) and average APC (AAPC) were calculated to evaluated trends. Relative survival was estimated to compare survival outcomes.Results: Vulvar cancer incidence rates were highest among non-Hispanic whites (20.9 per 1,000,000 person-years) and in the Midwest (27.7), while vaginal cancer rates were highest among non-Hispanic blacks (8.2) and in the South (6.7). Overall, vulvar cancer rate increased 0.4% annually (AAPC, 0.4%; 95% CI, 0.1% to 0.6%), but vaginal cancer rate decreased 1.4% annually (AAPC, -1.4%; 95% CI, -2.0% to -0.5%). The increased vulvar cancer rate was only observed for squamous cell carcinoma (APC, 1.0%), while the decreased vaginal cancer rate was only observed for other malignancies (APC, -1.7%). Vulvar cancer rates increased only among whites (APC, 1.2%), but vaginal cancer rates decreased only among whites (AAPC, -1.3%) and Asians (APC, -2.7%). Vulvar cancer rates increased among patients aged 50-59 (APC, 1.1%), 60-69 (APC, 1.3%), and 70-79 (APC, 1.2%) years, while vaginal cancer rates decreased among patients aged 50-59 (APC, -1.4%) and 80 (APC, -1.4%) years or older. Overall, whites had the highest five-year relative survival for both vulvar (72.22%) and vaginal (49.03%) cancers. Conclusion: There were profound disparities in vulvar and vaginal cancer incidence rates attributable to histological type, race, age, and region. The increased vulvar cancer rates and the declined vaginal cancer rate highlights the importance of further studies to investigate the reason for the disparities.

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“…This might be due to the higher incidence of distant pancreatic cancer in black patients. [4] Compared with the traditional AJCC stage, all the C-index of our model were more than 0.72, indicating a better discrimination and the ability to provide individualized prediction for patients.…”

Section: Manuscript To Be Reviewedmentioning

confidence: 75%

“…A survey based on the SEER database found that the incidence of PC among young whites and blacks increased by 57% between 2001 and 2015. [4] In addition, another epidemiological study found that from 1992 to 2013, the annual percentage change in the incidence of PC in women aged 25-34 was more than 2.5%. [5] The median age of diagnosis of PC is 71 years old.…”

Section: Introductionmentioning

confidence: 98%

Peer Review #1 of "Nomograms for predicting overall survival and cancer-specific survival in young patients with pancreatic cancer in the US based on the SEER database (v0.2)"

2020

View full text Add to dashboard Cite

Background: The incidence of young patients with pancreatic cancer (PC) is on the rise, and there is a lack of models that could effectively predict their prognosis. The purpose of this study was to construct nomograms for predicting the overall survival (OS) and cancer-specific survival (CSS) of young patients with PC. Methods: PC patients younger than 50 years old from 2004 to 2015 in the Surveillance, Epidemiology, and End Results (SEER) database were selected and randomly divided into training set and validation set. Univariate and forward stepwise multivariate Cox analysis was used to determine the independent factors affecting OS. Fine and Gray competing risk regression model was used to determine the independent factors affecting CSS. We used significant variables in the training set to construct nomograms predicting prognosis. The discrimination and calibration power of models were evaluated by concordance index (C-index), calibration curve and 10-flod cross-validation. Results: 4,146 patients were selected. Multivariate Cox analysis showed that gender, race, grade, pathological types, AJCC stage and surgery were independent factors affecting OS. The C-index of the nomogram predicting OS in training and validation was 0.733 (average=0.731,95%CI=0.724-0.738) and 0.742 (95%CI=0.725-0.759), respectively. Competing risk analysis showed that primary site, pathological types, AJCC stage and surgery were independent factors affecting CSS. The C-index of the nomogram predicting CSS in training and validation set was 0.792 (average=0.765, 95%CI=0.742-0.788) and 0.776 (95%CI=0.773-0.779), respectively. C-index based on nomogram was better in training and validation set than that based on AJCC stage. Calibration curves showed that these nomograms could accurately predict the 1-, 3-and 5-year OS and CSS both in training set and validation set. Conclusions: The nomograms could effectively predict OS and CSS in young patients with PC, which help clinicians more accurately and quantitatively judge the prognosis of individual patients.

show abstract

Racial Disparities and Trends in Pancreatic Cancer Incidence and Mortality in the United States

Cited by 88 publications

References 35 publications

Nomograms for predicting overall survival and cancer-specific survival in young patients with pancreatic cancer in the US based on the SEER database

Nomograms for predicting overall survival and cancer-specific survival in young patients with pancreatic cancer in the US based on the SEER database

Rising and Falling Trends in Incidence Rates of Vulvar and Vaginal Cancers in the United States, 2000-2016

Peer Review #1 of "Nomograms for predicting overall survival and cancer-specific survival in young patients with pancreatic cancer in the US based on the SEER database (v0.2)"

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