The Impact of Race, Age, and Sex in Follicular Lymphoma (FL): A Comprehensive SEER Analysis in the Pre- and Post-Rituximab Eras

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1576-1576
Author(s):  
Chadi Nabhan ◽  
Briseis Aschebrook-Kilfoy ◽  
Brian C-H Chiu ◽  
Kimberly Kruczek ◽  
Anand Patel ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Racial Disparity ◽  
Conflicts Of Interest ◽  
Age Groups ◽  
Population Based ◽  
Low Ses ◽  
Asian Pacific Islander ◽  
Asian Pacific ◽  
The Impact ◽  
Persistent Inequality

Abstract Abstract 1576 Background: While racial disparity has been documented in a number of cancers, the impact of race, sex, and socioeconomic status (SES) on FL outcomes is not well defined. Furthermore, the impact of modern therapeutics on these disparities has not been fully explored. Methods: We examined population-based FL overall survival (OS) data from SEER 13 (1993–2008) for race, sex, age, and socioeconomic status (SES) over two consecutive 8-year periods: Era 1 (1993–2000, n=7,409) and Era 2 (2001–2008, n=9,083). Results: We identified a total 16,492 FL patients (pts) (white (W): n=13,441 (81.5%); Hispanic (H): n=1,417 (8.5%); Asian/Pacific Islander (A/PI): n=887 (5.3%); and Black (B): n=747 (4.5%)). Median age at diagnosis differed significantly according to race: (in years, yrs) W: 62.1, H: 57.3, A/PI: 60.5, B: 56.6; P<0.01 for each race vs. W. For all pts, OS was superior in Era 2 vs. Era 1 (5-yr OS: 77% vs. 68%, respectively, P<0.0001). Further, OS was significantly improved for all age groups (<50, 50–59, 60–69, and 70–79 yrs) as well as for males (P=0.0019) and females (P<0.0001) across eras. Interestingly, females had superior OS compared with males in Era 1 (P=0.004), but not in Era 2 (P=0.83). We subsequently compared OS within and across races (see Table). All races, except A/PI, had improved 5-yr OS rates (age adjusted) from Era 1 to Era 2 (W: <0.001, H: 0.049, A/PI: 0.15, B: 0.003). Notably, A/PIs had the highest OS in Era 1, while H had the poorest OS in Era 2. These differences were more evident in males compared with females within each race. Finally, pts with higher SES had improved OS compared with low SES in both eras (P=0.02 in era 1 and <0.0001 in era 2), although OS was improved across eras within low and high SES populations (P<0.0001). Conclusions: Collectively, we identified improved OS in FL across eras, which was apparent for all ages, both sexes, and all races. However, racial disparities persist, including inferior OS for H and superior OS for A/PIs in the contemporary era. The disproportionate improvement in OS over eras and persistent inequality in outcomes based on race warrants continued examination. Disclosures: No relevant conflicts of interest to declare.

The impact of race, age, and sex in follicular lymphoma (FL): A comprehensive SEER analysis in the pre- and post-rituximab (R) eras.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 8072-8072
Author(s):  
Chadi Nabhan ◽  
Briseis Aschebrook-Kilfoy ◽  
Brian C-H Chiu ◽  
Kimberly R. Kruczek ◽  
Angelo Clemenzi-allen ◽  
...  
Keyword(s):  
Overall Survival ◽  
Racial Disparities ◽  
Racial Disparity ◽  
Age Groups ◽  
Population Based ◽  
Asian Pacific Islander ◽  
Asian Pacific ◽  
The Impact ◽  
Modern Era ◽  
Age And Sex

8072 Background: While racial disparity has been well documented in a number of cancers, the impact of race in FL outcomes is not well defined. Further, the importance of gender in FL has not been fully explored. Methods: We examined population-based FL overall survival (OS) data from SEER 13 (1993-2008) regarding race, sex, age, and socioeconomic status (SES) over two consecutive 8-year (yr) periods: Era 1 (1993-2000, n=7,409) and Era 2 (2001–2008, n=9,083). Results: We identified16,492 FL patients (pts) (white (W): n=13,441; Hispanic (H): n=1,417; Asian/Pacific Islander (A/PI): n=887; and Black (B): n=747). Median ages at diagnosis differed significantly according to: (in yrs, W: 62.1, H: 57.3, A/PI: 60.5, B: 56.6; P<0.01 for each race vs. W). For all pts, OS was superior in Era 2 vs. Era 1 (5-yr OS: 77% vs. 68%, respectively, P<0.0001). Further, OS was significantly improved for all age groups (<50, 50-59, 60-69, and 70-79 yrs) as well as for males (P=0.0019) and females (P<0.0001) across eras. Interestingly, females had superior OS compared with males in Era 1 (P=0.004), but not in Era 2 (P=0.83). We subsequently compared OS within and across races (Table). All races, except A/PI, had improved 5-yr OS rates (age adjusted) from Era 1 to Era 2 (W: <0.001, H: 0.049, A/PI: 0.15, B: 0.003). Notably, A/PIs had the highest OS in Era 1, while H had the poorest OS in Era 2. These differences were more evident in males compared with females within each race. Finally, pts with higher SES had better OS in both eras, although OS was improved across eras for lower and higher SES populations. Conclusions: Collectively, we identified improved OS across eras, which was apparent for all ages, both sexes, and all races. We did not find superior outcome for females in the modern era as has been recently noted. However, several racial disparities persist, including inferior OS for H and superior OS A/PIs in the contemporary era. The disproportionate improvement in outcomes for some, but not all races, warrants continued study of racial disparities in FL. [Table: see text]

6074Cardiorespiratory fitness, socioeconomic status and mortality in middle-aged men: a population-based prospective cohort study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Y Jae ◽  
S Kurl ◽  
B A Franklin ◽  
J Choo ◽  
H J Kim ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Heart Disease ◽  
Density Lipoprotein ◽  
Population Based ◽  
Lipoprotein Cholesterol ◽  
Low Ses ◽  
Risk Of Death ◽  
Increased Risk ◽  
Material Standard Of Living ◽  
Cvd Mortality

Abstract Background Although both low socioeconomic status (SES) and poor cardiorespiratory fitness (CRF) are associated with increased chronic disease and a heightened risk of death, it remains unclear whether moderate-to-high levels of CRF confer survival benefits in low SES populations. Purpose The present study evaluated the hypothesis that SES and CRF predict all-cause mortality (ACM), cardiovascular disease (CVD) mortality and sudden cardiac death (SCD), and that moderate-to-high levels of CRF may attenuate the associations between low SES and adverse cardiovascular outcomes. Methods This prospective study was based on a population-based sample of 2,368 men aged 42 to 61 years, who were followed in the Kuopio Ischemic Heart Disease cohort. CRF was directly measured by peak oxygen uptake (VO2peak) during progressive exercise testing to volitional fatigue. SES was characterized using self-reported questionnaires via combined measures of income, education, occupation, occupational prestige, material standard of living, and housing conditions. CRF and SES were divided into tertiles, and 4 combined groups (Fit-high SES, Fit-low SES, Unfit-high SES, and Unfit-low SES) based on the median values of CRF and SES. Results During a 25 year median follow-up (interquartile ranges: 18–27 years), 1116 ACM, 512 CVD mortality and 221 SCD events occurred. After adjusting for potential confounders (age, smoking, alcohol, body mass index, systolic blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, glucose, diabetes, hypertensive medication, family history of coronary heart disease, and physical activity), the lowest levels of SES were at significantly increased risk for ACM (hazard ratio (HR) 1.49, 95% Confidence Interval (CI): 1.30–1.71), CVD mortality (HR 1.38, 1.13–1.69) and SCD (HR 1.34, 0.97–1.84). In contrast, higher levels of CRF were associated with lower risks of ACM (HR 0.56, 0.46–0.67), CVD mortality (HR 0.53, 0.40–0.71) and SCD (HR 0.53, 0.34–0.83). In combined associations of SES and CRF with mortality, unfit-low SES had significantly higher risks of ACM (HR 2.12, 1.75–2.57), CVD mortality (HR 2.20, 1.64–2.94) and SCD (HR 2.95, 1.79–4.86), but fit-low SES was not associated with a heightened risk of cardiovascular mortality or SCD (CVD mortality, 1.03, 0.73–1.46; SCD, 1.54, 0.87–2.72) as compared with their fit-high SES counterparts (reference). Conclusion Our findings indicate that both SES and CRF are independently associated with the risk of death; however, moderate-to-high levels of CRF appear to attenuate the risk of CVD mortality and SCD in low SES men. These unique data have important implications for public health interventions designed to enhance survival in underserved population cohorts.

scholarly journals Impact of Socioeconomic Status on Return to Work after Acute Ankle Fracture

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0020
Author(s):  
Alessandra L. Falk ◽  
Regina Hanstein ◽  
Chaiyaporn Kulsakdinun
Keyword(s):  
Socioeconomic Status ◽  
Return To Work ◽  
Low Socioeconomic Status ◽  
Ankle Fracture ◽  
Low Ses ◽  
Insurance Status ◽  
Low Socioeconomic ◽  
The Impact ◽  
Zip Code

Category: Ankle; Trauma Introduction/Purpose: Socioeconomic status has been recognized throughout the medical literature, both within orthopedics and beyond, as a factor that influences outcomes after surgery, and can result in substandard care. Within the foot and ankle subspecialty, there is limited data regarding socioeconomic status and post-operative outcomes, with the current literature focusing on outcomes for diabetic feet. However, ankle fractures are among the most common fractures encountered by orthopedic surgeons. While a few studies have explored the impact of ankle fractures on employment and disability status, the effect of socioeconomic status on return to work post operatively has not yet been investigated. The purpose of this study was to determine the impact of low socioeconomic status on return to work. Methods: We retrospectively reviewed 592 medical charts of patients with CPT code 27766, 27792, 27814, 27822, 27823, 27827, 27829, 27826, 27828 from 2015-2018. Included were patients >18 yrs of age who sustained an acute ankle fracture, were employed prior to the injury, and with information on return to work after ankle surgery, zip code, race, ethnicity and insurance status. Excluded were patients who were not employed prior to their injury. Socioeconomic status was either defined by insurance status - Medicaid/Medicare, commercial, or workman’s compensation -, or by assessing socioeconomic status (SES) using medial household per capita income by zip code as generated and reported by the US National Census Bureau’s 2013-2017 American Community Survey 5-Year Estimates. The national dataset was divided into quartiles with the lowest quartile defined as low SES. Patients who had income that fell within this income category were classified as low SES. Results: 174 patients were included with an average follow-up of 10.2months. 22/174 (12.6%) patients didn’t return to work post-operatively. Univariate analysis identified non-sedentary work to decrease the likelihood of return to work (HR:0.637; p=0.03). Patients with a low SES were more prevalent in the no return group compared to the return to work group (86% vs 60%; p=0.028). 95% of patients with low SES were a minority compared to 56% with average/high SES (p<0.005). Patients with low SES had a higher BMI (p=0.026), a longer hospitalization (p=0.04) and more wound complications (p=0.032). Insurance type didn’t affect return to work (p=0.158). Patients with workman’s compensation had a longer follow-up time and a longer time to return to work compared to other insurances (p<0.005 for each comparison). Conclusion: Low socioeconomic status based on income, not insurance type, affected return to work after an ankle fracture ORIF. Patients with workman’s compensation took a longer time to return to work compared to other insurance types. These findings warrants the need to consider socioeconomic status when allocating resources to treat these patients.

scholarly journals Evaluation of community coalition training effects on youth hospital-admitted injury incidence in Victoria, Australia: 2001–2017

2019 ◽  
Vol 26 (5) ◽  
pp. 463-470 ◽  
Author(s):  
Janneke Berecki-Gisolf ◽  
Bosco Rowland ◽  
Nicola Reavley ◽  
Barbara Minuzzo ◽  
John Toumbourou
Keyword(s):  
Risk Factors ◽  
Injury Risk ◽  
Negative Binomial ◽  
Hospital Admissions ◽  
Intervention Strategy ◽  
Age Groups ◽  
Negative Binomial Regression ◽  
Population Based ◽  
Injury Incidence ◽  
The Impact

BackgroundInjuries are one of the three leading causes of morbidity and mortality for young people internationally. Although community risk factors are modifiable causes of youth injury, there has been limited evaluation of community interventions. Communities That Care (CTC) offers a coalition training process to increase evidence-based practices that reduce youth injury risk factors.MethodUsing a non-experimental design, this study made use of population-based hospital admissions data to evaluate the impact on injuries for 15 communities that implemented CTC between 2001 and 2017 in Victoria, Australia. Negative binomial regression models evaluated trends in injury admissions (all, unintentional and transport), comparing CTC and non-CTC communities across different age groups.ResultsStatistically significant relative reductions in all hospital injury admissions in 0–4 year olds were associated with communities completing the CTC process and in 0–19 year olds when communities began their second cycle of CTC. When analysed by subgroup, a similar pattern was observed with unintentional injuries but not with transport injuries.ConclusionThe findings support CTC coalition training as an intervention strategy for preventing youth hospital injury admissions. However, future studies should consider stronger research designs, confirm findings in different community contexts, use other data sources and evaluate intervention mechanisms.

The Impact of Race, Age, and Sex in Chronic Lymphocytic Leukemia (CLL): A Comprehensive SEER Analysis in the Pre and Post Rituximab (R) Eras.

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 2877-2877
Author(s):  
Chadi Nabhan ◽  
Briseis Aschebrook-Kilfoy ◽  
Andrew M. Evens ◽  
Brian C-H Chiu ◽  
Sonali M. Smith ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Survival Data ◽  
Research Funding ◽  
Combined Therapy ◽  
Age Groups ◽  
Poverty Line ◽  
Preliminary Evidence ◽  
Lymphocytic Leukemia ◽  
Male Predominance ◽  
The Impact

Abstract Abstract 2877 Background: Racial disparity has been well documented in a number of cancers but the impact of race on CLL in the contemporary era is unclear. While preliminary evidence suggests that Black (B) patients (pts) have worse survival than their White (W) counterparts (Shenoy et al, Clin Lymph Myleoma Leuk, 12/2011), the importance of sex, age, socioeconomic status (SES), and whether the wide use of single use or combined therapy with R in CLL over the last decade plus has affected overall survival (OS) have not been fully explored. Further, outcome of Hispanic (H) and Asian/Pacific Islanders (A/PI) CLL pts has not been fully studied. Methods: We examined population based survival data from SEER 13 (1993–2008) for CLL within and across various races. We also investigated the impact of sex, age, and socioeconomic status (SES) on their clinical outcome. Outcomes were examined over two consecutive 8-year (yr) periods: Era-1 (1993–2000) and Era-2 (2001–2008) with the assumption of R therapy in CLL patients being more frequent after 2001 (market research data not shown). Results: We identified 24,964 pts [W =21,363 (85.5%), H =1,197 (4.7%), B =1,709 (6.8%), and A/PI =695 (2.7%)]. Differences were notable for a greater male predominance among A/PI [62% vs. 57% (B), 56% (H), 58% (W); P=0.03]; a higher proportion of pts >80 among W [22% vs. 17% (H), 15% (B), 16% (A/PI); P<0.001], and higher SES among A/PI and W pts compared to B and H (P<0.001). OS for all patients was significantly better in Era-2 vs. Era-1 at 5-yrs (65% vs. 60.4%, P<0.0001). This improvement was statistically significant in all races except A/PI pts (P=0.71) (Table). Improved survival across eras was also noted in all age groups (<50 (P<0.00001), 50–59 (P=0.007), 60–69 (P<0.0001), 70–79 (P<0.0001), >80 yrs (P<0.0001)). Further, improved OS was noted in the two SES classes evaluated (0–15% and 15.1–30% below poverty line respectively). While there were no statistical differences between males and females within either era, improvement in OS was noted in both sexes in Era-2 versus Era-1 (P<0.0001). We subsequently compared OS within and across races (Table). Despite the fact that OS improved in all races, W pts continued to have better OS in Era-2. In Era-1, while W pts had better OS than B and H pts, the OS is similar between W and A/PI. Although OS improved in all SES classes, patients with higher SES continued to have better OS in Era-2 (P<0.0001 for both). Conclusions: The OS of CLL pts has improved in the contemporary era for both sexes, all age groups, and all races except A/PI individuals. The improvement in outcome in Era-2 might be partially explained by increased use of R and other novel agents that became available after 2001. Despite the broad nature of these improvements, racial and SES differences in the survival persist and deserve further validation and pursuit of the causes. Disclosures: Shanafelt: Genentech: Research Funding; GlaxoSmith Klein: Research Funding; Teva/Cephalon: Research Funding; Celgene: Research Funding. Kay:Genentech: Research Funding; Glaxosmith Klein: Research Funding.

Impact Of Age On Toxicity Associated With Chemotherapy For Acute Lymphoblastic Leukaemia (ALL): Results From The UK Prospective Study UKALL2003

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 840-840
Author(s):  
Rachael E. Hough ◽  
Clare Rowntree ◽  
Rachel Wade ◽  
Nicholas Goulden ◽  
Chris Mitchell ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Residual Disease ◽  
Age Groups ◽  
Serious Adverse Events ◽  
Number Of Patients ◽  
Teenagers And Young Adults ◽  
The Uk ◽  
Cure Rates ◽  
The Impact

Abstract Despite the substantial improvements made in the outcomes of paediatric ALL, with ‘cure' rates now in excess of 90%, survival in teenage and young adult (TYA) patients has remained inferior. The reasons for this are likely multifactorial, including tumour biology, toxicity, compliance, access to clinical trials and protocol (adult or paediatric) used. We report the toxicity profiles observed in children, teenagers and young adults treated on the UK intensive, minimal residual disease (MRD) directed ALL protocol, UKALL2003. Of a total of 3126 patients treated, 1520 patients were under 5 years old, 767 were aged 5-9 years, 610 aged 10-15 years and 229 aged 16-24 years, with a median overall follow-up of 4 year and 10 months. The risk of serious adverse events (SAEs) was higher in patients older than 10 years (56% in 10-15 year olds, 53% in 16-24 year olds) compared to those aged 9 or younger (30% in under 5 years and 31% in 5-9 years)(p<0.0001), with no difference in the those aged 16-24 compared to younger teenagers (p=0.5). The incidence (per number of patients in each group) and distribution of toxicities according to age group is summarised in the table.Table 1Age in years<55-910-1516-24AllTotal number of patients1520767610229 NB: 56 pts≥20 years3126Infection n (%)328 (21.6%)130 (17.0%)145 (23.8%)72 (31.4%)675 (21.6%)Asaparaginase n (%)57 (3.8%)57 (7.4%)64 (10.5%)31 (13.5%)209 (6.7%)Methotrexate n (%)100 (6.6%)74 (9.6%)123 (20.2%)33 (14.4%)330 (10.6%)Steroid n (%)54 (3.6%)37 (4.8%)141 (23.1%)52 (22.7%)284 (9.0%)Vincristine n (%)34 (2.2%)11 (1.4%)22 (3.6%)7 (3.0%)74 (2.4%)Other SAEs94 (6.2%)42 (5.5%)90 (14.8%)25 (10.9%)251 (8.0%) The incidence of certain toxicities including viral infection (5.3%), asparaginase hypersensitivity (1.9%) and vincristine neurotoxicity (2.1%) appeared equivalent across all age groups. Avacular necrosis was seen predominantly in adolescents (83% of 147 events in 10-19 year olds) and was rare in those younger than 10 years (n=18) or older than 20 years (n=7). Asparaginase thrombotic events increased in frequency with increasing age (1.5% in under 5 years, 3.3% in 5-9 years, 4.4% in 10-15 years and 8.3% in 16-24 year olds)(p<0.0001). All other toxicities were more frequently observed in over 10 year olds compared to patients aged 9 or younger, with no difference between 16-24 year olds and 10-15 year olds. The impact of age on SAEs associated with intensive ALL chemotherapy varies according to specific toxicities. In general, toxicity is higher in those over 10 years compared to younger patients, with no excess toxicity in those aged 16-24 compared to 10-15 years. However, specific toxicities may increase with increasing age (thrombosis), be restricted to adolescence (AVN) or be unrelated to age (vincristine neurotoxicity, asparaginase hypersensitivity). Disclosures: No relevant conflicts of interest to declare.

Impact of socioeconomic status on extent of disease at diagnosis and cancer and ocular outcomes in retinoblastoma: A population-based analysis.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 10011-10011
Author(s):  
Bao Truong ◽  
Adam L. Green ◽  
Paola Friedrich-Medina ◽  
Junne Kamihara ◽  
A. Lindsay Frazier ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Relative Survival ◽  
Lower Percentage ◽  
Low Ses ◽  
Education Attainment ◽  
Poverty Level ◽  
Hispanic Origin ◽  
Hispanic Patients ◽  
The Impact ◽  
Extent Of Disease

10011 Background: The strong correlation between early diagnosis and improved outcomes has been consistently reported for retinoblastoma; extent of disease and eye preservation are associated with delayed diagnosis. In this study, we aimed to analyze the impact of socioeconomic status (SES) and ethnicity on extent on disease and cancer and ocular outcomes. Methods: All retinoblastoma cases (0-9 years) recorded in 18 SEER registries between 2000-2009 were included. The county-based disparity variables analyzed included poverty level, education attainment, language isolation, crowding, and percentage of immigrants. The cut-off values were defined as the median values for the cohort of patients. We also analyzed the impact of gender, race, and ethnicity. We tested for the association between SES and ethnicity with the percentage of extraocular disease and enucleation. Relative survival was calculated using Ederer II method; estimates were compared using Z-score. Results: We identified 753 cases. Percentage of extraocular cases was consistently higher in US counties with low SES indicators: higher vs. lower poverty status (29.3% vs. 22.1%, p=0.028); lower vs. higher education attainment (30.6% vs. 22.7%, p=0.003); higher vs. lower crowding (33.2% vs. 18.1%, p<0.001); higher vs. lower language isolation (32.2% vs. 19.3%, p<0.001); higher vs. lower percentage of immigrants (30.1% vs. 21.4%, p=0.008). Hispanic patients had significantly higher percentage of extraocular disease (35.2% vs. 20.9%, p<0.001). Poor ocular outcomes, reflected by high percentage of enucleation, were associated with counties with low education attainment (p=0.025), and with Hispanic origin (p=0.019). Decreased survival was associated with language isolation (p=0.016), but not with Hispanic origin or other SES indicators. Conclusions: Our study highlights significant disparities in the care and outcome of children with retinoblastoma. A low SES negatively impacts extent of disease, presumably by limiting access to primary care and delaying diagnosis. Hispanic patients have more advanced disease and higher enucleation rates, although survival is not significantly different.

Impact of socioeconomic status and degree of ethnic isolation on cervical cancer incidence among Hispanics and Asians in California.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5605-5605
Author(s):  
Marie-Anne Froment ◽  
Audrey Roux ◽  
Mindy C. DeRouen ◽  
Scarlett Lin Gomez ◽  
Elizabeth A. Kidd
Keyword(s):  
Cervical Cancer ◽  
Socioeconomic Status ◽  
Cancer Incidence ◽  
Pap Smear ◽  
Invasive Cervical Cancer ◽  
The United States ◽  
Asian Women ◽  
Low Ses ◽  
Cervical Cancer Incidence ◽  
The Impact

5605 Background: The incidence of cervical cancer in the United States has declined since the introduction of the pap smear. However, differences exist based on ethnicity and socioeconomic status (SES).This study aimed to evaluate the impact of nativity, neighborhood SES and enclave (degree of ethnic isolation) on the incidence of cervical cancer in California. Methods: Using data from the California Cancer Registry, comprising three of the National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) program registries, information on all primary invasive cervical cancer diagnosed in California from January 1, 1990, through December 31, 2004 was obtained. We analyzed the influence of enclave, SES, and nativity on cervical cancer incidence. Results: Among the 22,189 invasive cervical cancer cases diagnosed between 1990 and 2004, 50% were non-Hispanic white (NHW), 39% Hispanic and 11% Asian women. Seventy percent (70%) of the invasive cervical cancer cases were squamous cell carcinoma (SCC), 19% were adenocarcinoma and 11% other histologies. Approximately half (51%) of patients presented with localized disease, 33% regional disease, 10% distant disease and 6% unknown. By ethnic group, US born women showed lower rates of SCC compared to foreign-born women. Seventy-six percent (76%) of invasive cervical cases were observed in high enclave neighborhoods, and seventy percent (70%) were noted in low SES neighborhoods. Hispanics living in low SES and high enclave had 12.7 times (95% CI; 11.2-14.3) higher rate of cervical cancer than those living in high SES, low enclave neighborhoods. For Asian women incidence rates were 6 times (95% CI; 4.9-7.5) higher in the low SES, high enclave neighborhoods compared to those living in high SES, low enclave neighborhoods. Conclusions: More efforts should be done to reach out to and increase pap smear screening for women living in high enclave neighborhoods to help decrease the incidence of invasive cervical cancer cases in these groups of women.

Impact of care at NCI comprehensive cancer centers (NCICCC) on outcomes in children, adolescents, and young adults (AYA) with central nervous system tumors (CNSt).

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 123-123
Author(s):  
Julie Anna Wolfson ◽  
Can-Lan Sun ◽  
Tongjun Kang ◽  
Smita Bhatia
Keyword(s):  
Population Based ◽  
Low Ses ◽  
Who Grade ◽  
Barriers To Access ◽  
Race Ethnicity ◽  
Grade 3 ◽  
And Gender ◽  
Evidence Based Care ◽  
The Impact ◽  
To Receive

123 Background: AYA (15-39yo) have not seen the same survival improvement as younger cancer patients with similar diagnoses (dx), leaving an AYA Gap. Treatment on pediatric trials is associated with superior survival in 15-21yo. However, impact of care at NCICCC for complex diseases with poor prognosis that require evidence-based care available at NCICCC (e.g. CNSt), remain unstudied. Methods: We constructed a cohort of 560 children (0-14yo) and 785 AYA with newly-dx CNSt, reported to the LA County (LAC) cancer registry between 1998 and 2008. While 82% of children (0-14y) and 65% of young AYA (15-18y) were treated at one of 3 NCICCC or 3 COG sites in LAC, only 17% of older AYA (19-39y) were treated at one of 3 NCICCC. We sought to determine the impact of NCICCC/COG on overall survival (OS) and barriers to access to care at NCICCC/COG in AYA with CNSt. Since distance to NCICCC/COG could serve as a barrier to accessing care, Geographic Information Systems were used to derive distance between patient’s residence to the nearest NCICCC/COG. Results: OS rates were uniformly good for children and AYA with grade 1 CNSt (96 vs. 89% at 5y, p=0.2) and uniformly poor for children and AYA with grade 3/4 CNSt (43 vs. 43% at 5y, p=0.6). Among patients with WHO grade 2 CNSt, AYA had worse outcome (HR=1.9, p<0.01) after adjustment for race/ ethnicity, SES, and gender. This difference in outcome between AYA and children was abrogated by care at NCICCC (HR 1.4, p=0.2). Furthermore, patients cared at non-NCICCC saw worse outcome (HR=1.6, p=0.04). Compared with children, young AYA (15-18yo) were less likely to receive care at NCICCC (OR=0.3, p=0.02); race/ ethnicity, SES and distance to NCICCC did not influence care at NCICCC. Among older AYA (19-39yo), low SES (OR 0.4, p=0.01), public/ no insurance (OR 0.3, p<0.01) and longer distance to NCICCC (5-12mi: OR=0.3 , p<0.01; >12mi OR 0.5 , p=0.05) reduced likelihood to receive care at NCICCC. Conclusions: Population-based data reveal that receipt of care at NCICCC abrogates the inferior outcome in AYA with WHO grade 2 CNSt. Young AYA are less likely to use NCICCC than children, as are older AYA with low SES, public/ no insurance, or living > 5 miles from an NCICCC.

Racial and socioeconomic disparities in follicular lymphoma survival.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18173-e18173
Author(s):  
Richard Stephen Sheppard ◽  
Adewumi Adekunle ◽  
Stefani Beale ◽  
Meena Ahluwalia
Keyword(s):  
Socioeconomic Status ◽  
Follicular Lymphoma ◽  
Low Socioeconomic Status ◽  
Survival Rates ◽  
The United States ◽  
Rank Test ◽  
Men And Women ◽  
Low Socioeconomic ◽  
Asian Pacific Islander ◽  
Asian Pacific

e18173 Background: Follicular Lymphoma (FL) is a the second most common Non Hodgkin's Lymphoma (NHL) diagnosed in the United States with 2.6 per 100,000 men and women per year from 2011 to 2015 when age adjusted as per the National Cancer Institute with the number of deaths of 0.5 per 100,000 men and women per year. It known that FL is one of the most clinically indolent NHL and due to this, survival rates are generally more favorable when compared to other B Cell Lymphomas. With this study, we aim to analyse socioeconomic and racial disparities in the survival rates for FL. Methods: The authors identified patients diagnosed with FL between 1973 and 2015 using the Surveillance, Epidemiology, and End Results (SEER) database. Overall survival was estimated and compared between racial/ethnic groups using the log-rank test. Our outcome variables were 1-year, 5-year and mortality. Our independent variables were race and socioeconomic status. We controlled for age, demographic characteristics, time of diagnosis, pathological classification, treatment and socioeconomic status. Results: A total of 66 127 patients were identified; 90% of the patients were White, 4% Black, and 4% Asian. We noted significant differences in disease presentation, socioeconomic status, and outcomes. Asian/Pacific Islander had the lowest survival with a mean of 228 survival months, Blacks had a mean survival months of 237, and Whites had a mean survival months of 234. Conclusions: Disparities exist in the care and outcomes of FL. A low socioeconomic status is correlated with decreased survival.

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