Patterns of Incidence and Survival of Therapy Related Myeloid Neoplasms in United States

Abstract Introduction: World Health Organization (WHO) classifies therapy-related myeloid neoplasms (t-MN) into therapy related acute myeloid leukemia (t-AML), therapy related myelodysplastic syndrome (t-MDS), and therapy related myelodysplastic syndrome/myeloproliferative neoplasms (t-MDS/MPN). These diseases are aggressive hematological malignancies and only allogeneic transplant offers the possibility of long-term remission. We performed retrospective analyses of Surveillance, Epidemiology, and End-Results (SEER) database to examine differences in incidence and survival outcomes of t-MN across different races and ethnicities in United States (US). Methods: Patients who developed t-MN following previous hematological or solid organ malignancies were included in the analyses. SEER registries classify race, ethnicity using 2000 US Census categories based on self- identification, medical records, death certificates and though linkage to Indian Health Service records. The race/ethnicity was categorized as non-Hispanic white (nHW), Hispanic white (HW), non-Hispanic Black (nHB), non-Hispanic Asian/Pacific islander (nHA/P), non- Hispanic American Indian/ Alaskan natives (nHI/A) and unknown groups (U). The patients were divided into various age group categories: <50 years, 50-59 years, 60-69 years, 70-79 years and >80 years. The statistical analyses were performed using SAS 9.4 software. Results: 13990 patients were reported to SEER database during 2000-2012 period with the diagnosis of t-MN. The total number of newly diagnosed t-MN in various racial groups was: nHW-11307, HW-900, nHB-1018, nHA/P-708, nHI/A -51 and U-6. There was higher reporting of non-Hodgkin lymphoma in females and lung/bronchial malignancies in males across all racial groups. Comparing different age groups, 50 months OS rates were: 2%, 6%, 13%,22% and 26% for groups >80 years, 70-79 years, 60-69 years, 50-59 years and <50 years, respectively. (figure 1). Males had worse OS when compared with females, however it was not significant after adjusting for age. The annual incidence of t-MN was highest amongst nHWs at 5.4 (5.3-5.4) per 100,000 and was lowest in American-Indian at 3.5 (3.0-4.0) per 100,000. The mean OS from the diagnosis of t-MN in nHW, HW, nHB, nHA/P and nHA/I was 11.1 mo, 12.35 mo, 11.86 mo, 12.1 mo and 11.41 mo respectively. When compared with HWs, nHWs had worse OS (p=<0.001). Similarly, when compared between HWs and nHBs, the mean OS was 12.35 months in HW population versus nHB population (OS=11.86 months) (p=<0.001). Overall, it was observed that HWs had better OS and presented with t-MN at younger age. Conclusion: In summary, the analyses of SEER database for t-MN revealed that t-MN developed in small proportion of patients exposed to cytotoxic agents or radiotherapy. nHWs non-had the highest incidence of reported t-MN, probably due to better access to healthcare and resources. There was statistically significant difference in the observed OS of HWs versus other ethnic groups. It appeared that the median age of diagnosis of t-MN in HW was 65 yrs, which made this racial group more likely to get definitive management for t-MN(allogeneic transplant). This might have contributed towards better overall survival in HW population. nHB group had statistically significant poor OS when compared with nHW or HW groups. The possible explanation could be, lack of access to healthcare, unable to get allogeneic transplant due to lack of donor availability or genetic variations such as polymorphisms in DNA repair enzymes and nucleotide excision repair pathways. The cancer survivors are living longer with novel treatment and are more likely to develop subsequent malignancies and population based studies are essential for identifying cohorts of at risk patients. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

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Alcohol Consumption and Chronic Liver Disease Mortality in New Mexico and the United States, 1999-2013

Public Health Reports ◽

10.1177/0033354918766890 ◽

2018 ◽

Vol 133 (3) ◽

pp. 287-293 ◽

Cited By ~ 3

Author(s):

Laura E. Tomedi ◽

Jim Roeber ◽

Michael Landen

Keyword(s):

United States ◽

New Mexico ◽

Liver Disease ◽

American Indian ◽

The United States ◽

Death Rates ◽

Attributable Fractions ◽

Hispanic Men ◽

Race Ethnicity ◽

Hispanic White

Objective: Current chronic liver disease (CLD) mortality surveillance methods may not adequately capture data on all causes of CLD mortality. The objective of this study was to calculate and compare CLD death rates in New Mexico and the United States by using both an expanded definition of CLD and estimates of the fractional impact of alcohol on CLD deaths. Methods: We defined CLD mortality as deaths due to alcoholic liver disease, cirrhosis, viral hepatitis, and other liver conditions. We estimated alcohol-attributable CLD deaths by using national and state alcohol-attributable fractions from the Centers for Disease Control and Prevention’s Alcohol-Related Disease Impact application. We classified causes of CLD death as being alcohol-attributable, non–alcohol-attributable, or hepatitis C. We calculated average annual age-adjusted CLD death rates during five 3-year periods from 1999 through 2013, and we stratified those rates by sex, age, and race/ethnicity. Results: By cause of death, CLD death rates were highest for alcohol-attributable CLD. By sex and race/ethnicity, CLD death rates per 100 000 population increased from 1999-2001 to 2011-2013 among American Indian men in New Mexico (67.4-90.6) and the United States (38.9-49.4), American Indian women in New Mexico (48.4-63.0) and the United States (27.5-39.5), Hispanic men in New Mexico (48.6-52.0), Hispanic women in New Mexico (16.9-24.0) and the United States (12.8-13.1), non-Hispanic white men in New Mexico (17.4-21.3) and the United States (15.9-18.4), and non-Hispanic white women in New Mexico (9.7-11.6) and the United States (7.6-9.7). CLD death rates decreased among Hispanic men in the United States (30.5-27.4). Conclusions: An expanded CLD definition and alcohol-attributable fractions can be used to create comprehensive data on CLD mortality. When stratified by CLD cause and demographic characteristics, these data may help states and jurisdictions improve CLD prevention programs.

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A Retrospective Analysis of Softball-Related Head and Facial Injuries Treated in United States Emergency Departments, 2013-2017

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119825660 ◽

2019 ◽

Vol 7 (2) ◽

pp. 232596711982566 ◽

Cited By ~ 1

Author(s):

John S. Strickland ◽

Marie Crandall ◽

Grant R. Bevill

Keyword(s):

United States ◽

Head Injuries ◽

The United States ◽

Weighted Estimate ◽

Body Parts ◽

Facial Injuries ◽

Closed Head Injuries ◽

Closed Head ◽

The Mean ◽

Race Ethnicity

Background: Softball is a popular sport played through both competitive and recreational leagues. While head and facial injuries are a known problem occurring from games, little is known about the frequency or mechanisms by which they occur. Purpose: To analyze head/face injury diagnoses and to identify the mechanisms associated with such injuries. Study Design: Descriptive epidemiological study. Methods: A public database was used to query data related to head/facial injuries sustained in softball. Data including age, sex, race/ethnicity, injury diagnosis, affected body parts, disposition, incident location, and narrative descriptions were collected and analyzed. Results: A total of 3324 head and face injuries were documented in the database over the time span of 2013 to 2017, resulting in a nationwide weighted estimate of 121,802 head/face injuries occurring annually. The mean age of the players was 21.5 ± 14.4 years; 72.1% of injured players were female, while 27.9% were male. The most common injury diagnoses were closed head injuries (22.0%), contusions (18.7%), concussions (17.7%), lacerations (17.1%), and fractures (15.1%). The overwhelming majority of injuries involved being struck by a ball (74.3%), followed by colliding with another player (8.3%), colliding with the ground or a fixed object (5.0%), or being struck by a bat (2.8%). For those injuries caused by a struck-by-ball incident, most occurred from defensive play (83.7% were fielders struck by a hit or thrown ball) as opposed to offensive play (12.3% were players hit by a pitch or runners struck by a ball). Although helmet usage was poorly tracked in the database, female players (1.3%) were significantly more likely to have been wearing a helmet at the time of injury than were male players (0.2%) ( P = .002). Conclusion: The present study demonstrates that a large number of head and face injuries occur annually within the United States as a result of softball play. A variety of injuries were observed, with the majority involving defensive players being struck by the ball, which highlights the need for more focus on player safety by stronger adherence to protective headgear usage and player health monitoring.

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Pediatric glioma and medulloblastoma risk and population demographics: a Poisson regression analysis

Neuro-Oncology Advances ◽

10.1093/noajnl/vdaa089 ◽

2020 ◽

Vol 2 (1) ◽

Author(s):

Ivo S Muskens ◽

Qianxi Feng ◽

Stephen S Francis ◽

Kyle M Walsh ◽

Roberta Mckean-Cowdin ◽

...

Keyword(s):

Poisson Regression ◽

Incidence Rates ◽

Seer Database ◽

Foreign Born ◽

Calendar Time ◽

Related Factors ◽

Annual Percent Change ◽

Pediatric Glioma ◽

Race Ethnicity ◽

Hispanic White

Abstract Background The incidence of pediatric brain tumors varies by race and ethnicity, but these relationships may be confounded by socioeconomic status (SES). In this study, the Surveillance, Epidemiology, and End Results Program (SEER) database was evaluated for associations between race/ethnicity and pediatric glioma and medulloblastoma risk with adjustment for SES. Methods Pediatric glioma and medulloblastoma cases from the SEER database (years: 2000–2016) were included. Differences in incidence rates by ethnicity, sex, age, and SES-related factors were evaluated by calculation of age-adjusted incidence rates (AAIRs) and annual percent change (APC). SES-related factors (percentage without less than high school graduation, median household income, and percentage foreign-born) were derived from the census at the county-level (year: 2000). Multivariable Poisson regression models with adjustment for selected covariates were constructed to evaluate risk factors. Results The highest AAIRs of pediatric glioma were observed among non-Hispanic Whites (AAIR: 2.91 per 100 000, 95%-CI: 2.84–2.99). An increasing incidence of pediatric glioma by calendar time was observed among non-Hispanic Whites and non-Hispanic Blacks (APC: 0.97%, 95%-CI: 0.28–1.68 and APC: 1.59%, 95%-CI: 0.03–3.18, respectively). Hispanic and non-Hispanic Black race/ethnicity was associated with lower risk when compared with non-Hispanic White (incidence rate ratios [IRRs]: 0.66, 95%-CI: 0.63–0.70; and 0.69, 95%-CI: 0.65–0.74, respectively). For medulloblastoma, the highest AAIR was observed for non-Hispanic Whites with a positive APC (1.52%, 95%-CI: 0.15–2.91). Hispanics and non-Hispanic Blacks had statistically significant lower IRRs compared with non-Hispanic Whites (IRRs: 0.83, 95%-CI: 0.73–0.94; and 0.72, 95%-CI: 0.59–0.87, respectively). Conclusion Non-Hispanic White race/ethnicity was associated with higher pediatric glioma and medulloblastoma IRRs in models with adjustments for SES.

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Differential Association of HIV Funding With HIV Mortality by Race/Ethnicity, United States, 1999-2017

Public Health Reports ◽

10.1177/0033354920912716 ◽

2020 ◽

Vol 135 (1_suppl) ◽

pp. 149S-157S

Author(s):

Benedict I. Truman ◽

Ramal Moonesinghe ◽

Yolanda T. Brown ◽

Man-Huei Chang ◽

Jonathan H. Mermin ◽

...

Keyword(s):

United States ◽

The United States ◽

Rate Of Change ◽

Fiscal Year ◽

Death Rates ◽

Black Residents ◽

Race Ethnicity ◽

Hiv Funding ◽

Racial Ethnic ◽

Hispanic White

Objective Federal funds have been spent to reduce the disproportionate effects of HIV/AIDS on racial/ethnic minority groups in the United States. We investigated the association between federal domestic HIV funding and age-adjusted HIV death rates by race/ethnicity in the United States during 1999-2017. Methods We analyzed HIV funding data from the Kaiser Family Foundation by federal fiscal year (FFY) and US age-adjusted death rates (AADRs) by race/ethnicity (Hispanic, non-Hispanic white, non-Hispanic black, and Asian/Pacific Islander and American Indian/Alaska Native [API+AI/AN]) from Centers for Disease Control and Prevention WONDER detailed mortality files. We fit joinpoint regression models to estimate the annual percentage change (APC), average APC, and changes in AADRs per billion US dollars in HIV funding, with 95% confidence intervals (CIs). For 19 data points, the number of joinpoints ranged from 0 to 4 on the basis of rules set by the program or by the user. A Monte Carlo permutation test indicated significant ( P < .05) changes at joinpoints, and 2-sided t tests indicated significant APCs in AADRs. Results Domestic HIV funding increased from $10.7 billion in FFY 1999 to $26.3 billion in FFY 2017, but AADRs decreased at different rates for each racial/ethnic group. The average rate of change in AADR per US billion dollars was −9.4% (95% CI, −10.9% to −7.8%) for Hispanic residents, −7.8% (95% CI, −9.0% to −6.6%) for non-Hispanic black residents, −6.7% (95% CI, −9.3% to −4.0%) for non-Hispanic white residents, and −5.2% (95% CI, −7.8% to −2.5%) for non-Hispanic API+AI/AN residents. Conclusions Increased domestic HIV funding was associated with faster decreases in age-adjusted HIV death rates for Hispanic and non-Hispanic black residents than for residents in other racial/ethnic groups. Increasing US HIV funding could be associated with decreasing future racial/ethnic disparities in the rate of HIV-related deaths.

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Religion across Axes of Inequality in the United States: Belonging, Behaving, and Believing at the Intersections of Gender, Race, Class, and Sexuality

Religions ◽

10.3390/rel11060296 ◽

2020 ◽

Vol 11 (6) ◽

pp. 296

Author(s):

Landon Schnabel

Keyword(s):

United States ◽

Black Women ◽

Sexual Minorities ◽

The United States ◽

Racial Groups ◽

Religion And Spirituality ◽

College Degree ◽

Sexual Minority Women ◽

Intersecting Identities ◽

Race Ethnicity

Much research considers group differences in religious belonging, behaving, and/or believing by gender, race, ethnicity, class, or sexuality. This study, however, considers all these factors at once, providing the first comprehensive snapshot of religious belonging, behaving, and believing across and within these axes of inequality in the United States. Leveraging unique data with an exceptionally large sample, I explore religion across 40 unique configurations of intersecting identities (e.g., one is non-Latina Black heterosexual college-educated women). Across all measures considered, Black women are at the top—however, depending on the measure, there are different subsets of Black women at the top. And whereas most sexual minorities are among the least religious Americans, Black sexual minorities—and especially those with a college degree—exhibit high levels of religious belonging, behaving, and believing. In fact, Black sexual minority women with a college degree meditate more frequently than any other group considered. Overall, whereas we see clear divides in how religious people are by factors like gender, education, and sexual orientation among most racial groups, race appears to overpower other factors for Black Americans who are consistently religious regardless of their other characteristics. By presenting levels of religious belonging, behaving, and believing across configurations of gender, race, ethnicity, class, and sexuality in the contemporary United States, this study provides a more complex and complete picture of American religion and spirituality.

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Hepatitis C–Related Mortality Among American Indian/Alaska Native Persons in the Northwestern United States, 2006-2012

Public Health Reports ◽

10.1177/0033354919887748 ◽

2019 ◽

Vol 135 (1) ◽

pp. 66-73

Author(s):

Sarah M. Hatcher ◽

Sujata Joshi ◽

Byron F. Robinson ◽

Thomas Weiser

Keyword(s):

United States ◽

Hepatitis C ◽

Mortality Rate ◽

American Indian ◽

Alaska Native ◽

Data Sets ◽

Standard Population ◽

The Us ◽

Hispanic White ◽

Related Mortality

Objective: American Indian and Alaska Native (AI/AN) persons are commonly misclassified in epidemiologic and administrative data sets. The race-corrected hepatitis C virus (HCV)–related mortality rate among AI/AN persons in the Northwest United States (Idaho, Oregon, and Washington State) is unknown. We quantified the disparity in HCV-related mortality between AI/AN persons and non-Hispanic white (NHW) persons in the Northwest during 2006-2012 after correcting misclassified AI/AN race. Methods: After conducting probabilistic record linkage between death records and the Northwest Tribal Registry, we calculated HCV-related mortality rates for AI/AN and NHW persons by using National Center for Health Statistics bridged-race estimates standardized to the US 2000 standard population. Results: The 2006-2012 aggregate age-adjusted HCV-related mortality rate per 100 000 population in the Northwest was 19.6 (95% confidence interval [CI], 17.3-22.2) for AI/AN persons and 5.9 (95% CI, 5.7-6.1) for NHW persons (rate ratio [RR] = 3.3; 95% CI, 3.0-3.8). The disparity was larger among females (RR = 4.6; 95% CI, 3.8-5.5) than among males (RR = 2.9; 95% CI, 2.5-3.4). Conclusion: The disproportionate rate of HCV-related mortality among AI/AN persons in the Northwest highlights the need to expand HCV education, screening, and treatment among this population.

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Incidence of testicular cancer in the United States from 1992 to 2009.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.6_suppl.339 ◽

2013 ◽

Vol 31 (6_suppl) ◽

pp. 339-339 ◽

Cited By ~ 2

Author(s):

Manas Nigam ◽

Brisa Aschebrook-Kilfoy ◽

Sergey Shikanov ◽

Scott E. Eggener

Keyword(s):

United States ◽

Testicular Cancer ◽

White Men ◽

The United States ◽

Incidence Rates ◽

The Us ◽

Hispanic Men ◽

Tumor Characteristic ◽

Race Ethnicity ◽

Hispanic White

339 Background: The incidence of testicular cancer (TC) increased in the US through 2003. However, little is known about these trends after 2003. We sought to determine trends in TC incidence based on race, ethnicity and tumor characteristics. Methods: TC incidence and tumor characteristic data from 1992-2009 were extracted from the Surveillance, Epidemiology, and End Results-13 (SEER) registry. Trends were determined using JoinPoint. Results: TC incidence in the US increased from 1992 (5.7/100,000) to 2009 (6.8/100,000) with annual percentage change (APC) of 1.1% (p < 0.001). TC rates were highest in non-Hispanic white men (1992: 7.5/100,000; 2009: 8.6/1000) followed by Hispanic men (1992: 4.0/100,000; 2009: 6.3/100,000) and lowest among non-Hispanic black men (1992: 0.7/100,000; 2009: 1.7/100,000). Significantly increasing incidence rates were observed in non-Hispanic white men (1.2%, p < 0.001) but most prominently among Hispanics, especially from 2002-2009 (5.6%, p < 0.01). A significant increase was observed for localized TC (1.21%, p < 0.001) and metastatic TC (1.43%, p < 0.01). Increased incidence occurred in localized tumors for non-Hispanic white men (1.56%, p <0.001), while Hispanic men experienced an increase in localized (2.6%, p < 0.001), regionalized (16.5% from 2002-09, p < 0.01), and distant (2.6%, p < 0.01) disease. Conclusions: Through 2009, testicular cancer incidence continues to increase in the United States, most notably among Hispanic men. [Table: see text]

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Hypertension Control in the United States 2009 to 2018: Factors Underlying Falling Control Rates During 2015 to 2018 Across Age- and Race-Ethnicity Groups

Hypertension ◽

10.1161/hypertensionaha.120.16418 ◽

2021 ◽

Author(s):

Brent M. Egan ◽

Jiexiang Li ◽

Susan E. Sutherland ◽

Michael K. Rakotz ◽

Gregory D. Wozniak

Keyword(s):

United States ◽

Blood Pressure ◽

Health Care ◽

Access To Care ◽

Odds Ratio ◽

Treatment Effectiveness ◽

The United States ◽

Hypertension Control ◽

Race Ethnicity ◽

Hispanic White

Hypertension control (United States) increased from 1999 to 2000 to 2009 to 2010, plateaued during 2009 to 2014, then fell during 2015 to 2018. We sought explanatory factors for declining hypertension control and assessed whether specific age (18–39, 40–59, ≥60 years) or race-ethnicity groups (Non-Hispanic White, NH [B]lack, Hispanic) were disproportionately impacted. Adults with hypertension in National Health and Nutrition Examination Surveys during the plateau (2009–2014) and decline (2015–2018) in hypertension control were studied. Definitions: hypertension, blood pressure (mm Hg) ≥140 and/or ≥90 mm Hg or self-reported antihypertensive medications (Treated); Aware, ‘Yes” to, “Have you been told you have hypertension?”; Treatment effectiveness, proportion of treated adults controlled; control, blood pressure <140/<90. Comparing 2009 to 2014 to 2015 to 2018, blood pressure control fell among all adults (−7.5% absolute, P <0.001). Hypertension awareness (−3.4%, P =0.01), treatment (−4.6%, P =0.004), and treatment effectiveness (−6.0%, P <0.0001) fell, despite unchanged access to care (health care insurance, source, and visits [−0.2%, P =0.97]). Antihypertensive monotherapy rose (+4.2%, P =0.04), although treatment resistance factors increased (obesity +4.0%, P =0.02, diabetes +2.3%, P =0.02). Hypertension control fell across age (18–39 [−4.9%, P =0.30]; 40–59 [−9.9%, P =0.0003]; ≥60 years [−6.5%, P =0.005]) and race-ethnicity groups (Non-Hispanic White [−8.5%, P =0.0007]; NHB −7.4%, P =0.002]; Hispanic [−5.2%, P =0.06]). Racial/ethnic disparities in hypertension control versus Non-Hispanic White were attenuated after adjusting for modifiable factors including education, obesity and access to care; NHB (odds ratio, 0.79 unadjusted versus 0.84 adjusted); Hispanic (odds ratio 0.74 unadjusted versus 0.98 adjusted). Improving hypertension control and reducing disparities require greater and more equitable access to high quality health care and healthier lifestyles.

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Racial and Ethnic Disparities in Heart and Cerebrovascular Disease Deaths During the COVID-19 Pandemic in the United States

Circulation ◽

10.1161/circulationaha.121.054378 ◽

2021 ◽

Author(s):

Rishi Wadhera ◽

Jose F. Figueroa ◽

Fatima Rodriguez ◽

Michael Liu ◽

Wei Tian ◽

...

Keyword(s):

United States ◽

Heart Disease ◽

Cerebrovascular Disease ◽

Ethnic Minorities ◽

Minority Group ◽

Ethnic Disparities ◽

The United States ◽

Race Ethnicity ◽

Racial Ethnic ◽

Hispanic White

Background: Cardiovascular deaths increased during the early phase of the COVID-19 pandemic in the United States. However, it is unclear whether racial/ethnic minorities have experienced a disproportionate rise in heart disease and cerebrovascular disease deaths. Methods: We used the National Center for Health Statistics to identify heart disease and cerebrovascular disease deaths for non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, and Hispanic individuals from March-August 2020 (pandemic period), as well as for the corresponding months in 2019 (historical control). We determined the age- and sex-standardized deaths per million by race/ethnicity for each year. We then fit a modified Poisson model with robust standard errors to compare change in deaths by race/ethnicity for each condition in 2020 vs. 2019. Results: There were a total of 339,076 heart disease and 76,767 cerebrovascular disease deaths from March through August 2020, compared to 321,218 and 72,190 deaths during the same months in 2019. Heart disease deaths increased during the pandemic in 2020, compared with the corresponding period in 2019, for non-Hispanic White (age-sex standardized deaths per million, 1234.2 vs. 1208.7; risk ratio for death [RR] 1.02, 95% CI 1.02-1.03), non-Hispanic Black (1783.7 vs. 1503.8; RR 1.19, 1.17-1.20), non-Hispanic Asian (685.7 vs. 577.4; RR 1.19, 1.15-1.22), and Hispanic (968.5 vs. 820.4, RR 1.18, 1.16-1.20) populations. Cerebrovascular disease deaths also increased for non-Hispanic White (268.7 vs. 258.2; RR 1.04, 95% CI 1.03-1.05), non-Hispanic Black (430.7 vs. 379.7; RR 1.13, 95% CI 1.10-1.17), non-Hispanic Asian (236.5 vs. 207.4; RR 1.15, 1.09-1.21), and Hispanic (264.4 vs. 235.9; RR 1.12, 1.08-1.16) populations. For both heart disease and cerebrovascular disease deaths, each racial and ethnic minority group experienced a larger relative increase in deaths than the non-Hispanic White population (interaction term, p<0.001). Conclusions: During the COVID-19 pandemic in the US, Black, Hispanic, and Asian populations experienced a disproportionate rise in deaths due to heart disease and cerebrovascular disease, suggesting that racial/ethnic minorities have been most impacted by the indirect effects of the pandemic. Public health and policy strategies are needed to mitigate the short- and long-term adverse effects of the pandemic on the cardiovascular health of minority populations.

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The influence of racial disparity on oncologic outcomes for patients with penile cancer: a SEER population-based study

10.21203/rs.3.rs-38046/v1 ◽

2020 ◽

Author(s):

Xiaohong Su ◽

Kaihui Wu ◽

Shuo Wang ◽

Bingkun Li ◽

Chuanyin Li ◽

...

Keyword(s):

United States ◽

Multivariate Analysis ◽

Racial Differences ◽

Racial Disparity ◽

Penile Cancer ◽

Univariate Analysis ◽

The United States ◽

Term Survival ◽

Race Ethnicity ◽

Hispanic White

Abstract Purpose: Penile cancer (PC) is an uncommon malignancy in the urinary system of males. The present study aims to compare survival outcomes of PC patients among racial/ethnic groups in the United States. Methods and materials: Patients with PC were identified in the Surveillance, Epidemiology, and End Results (SEER) registries from 2004 to 2015. The SEER database represents 28% of the U.S. population. Race/ethnicity was categorized as non-hispanic white (NHW), hispanic white (HW), black, Asian/Pacific Islander (A/PI), or American Indian/Alaskan native (AI/AN). Kaplan-Meier method with the log-rank test was used to assess cancer-specific survival (CSS) and overall survival (OS). Multivariate analysis was conducted using Cox’s proportional hazard model. Results: A total of 3955 patients with PC were included. There were significant differences in age, marital status, tumor location, histology, grade, lymphadenectomy, and radiotherapy according to race/ethnicity. Univariate analysis revealed that A/PIs were significantly associated with better CSS (p= 0.005) and OS (p= 0.025) for most subtypes. The 5-year CSS rates for NHWs, HWs, blacks, A/PIs and AI/ANs were 79.4%, 74.2%, 75.9%, 87.1%, and 78.9%, respectively. The 5-year OS rates for NHWs, HWs, blacks, A/PIs and AI/ANs were 63.4%, 64.1%, 60.5%, 73.0%, and 70.9%, respectively. After adjusting for other factors, racial disparity was an independent risk factor for CSS and OS in the multivariate analysis (p=0.010 and p=0.017, respectively). Conclusions: Our results suggested that racial differences existed among PC patients in the United States with respect to patient clinicopathological features and survival. Long-term survival disparities were evident in PC patients, that the survival of NHWs, HWs, and blacks was worse than that of A/PIs.

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