Racial and gender disparities in stage at diagnosis for bladder cancer: Results from the surveillance, epidemiology, and end results (SEER) program, 2007 to 2016.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e17032-e17032
Author(s):  
Sachin Gupta ◽  
Monika Joshi ◽  
Xingran Weng ◽  
Li Wang
Keyword(s):  
Bladder Cancer ◽  
Racial Disparity ◽  
Stage Iv ◽  
Gender Disparity ◽  
Gender Disparities ◽  
Seer Program ◽  
Insurance Status ◽  
Stage At Diagnosis ◽  
And Gender ◽  
End Results

e17032 Background: Little is known about the patterns of racial and gender disparities in bladder cancer (BC). This study will use national large database to explore those disparities. Methods: Data from the National Cancer Institute’sSurveillance, Epidemiology, and End Results (SEER) Program for cancer registries was used. Patients > = 18 years diagnosed with BC in the years 2007-2016 were identified from SEER 18 database. We used the data year 2007 because that was the year when insurance status was first collected in SEER. Chi-square tests and multinomial logistic regression were used. Results: A total of 78,151 (females: 25.58%) patients were included, with 82.74% being non-Hispanic whites, 5.83% non-Hispanic blacks, 6.69 % Hispanics and 4.74% others. Distribution of stage 0 through stage IV at diagnosis was 51.97%, 23.21%, 12.11%, 4.10% and 8.61% respectively. Blacks (P < 0.0001) and females (P < 0.0001) were diagnosed at later stages as in Table. e.g., 14.54% of blacks were diagnosed at stage IV, compared to 7.97% of whites; and 11.03% of females at stage IV vs. 7.77% of males. Racial disparity exists for any given insurance status. Within every age group, gender disparity exists. For example, for those under 50 years of age, 12.81% of women vs. 8.16% of men were diagnosed at stage IV. After controlling for age, marital status and insurance type, both gender (P < 0.0001) and race (P < 0.0001) were statistically significant in predicting stage at diagnosis. Conclusions: Racial disparity in stage at BC diagnosis was strong, with blacks suffering most from the disparity. Females were more likely to be diagnosed at later stages, and this gender disparity exists in all age groups and was not due to women living longer. The existence of both racial and gender disparities in BC makes black women most vulnerable to late diagnosis than any other racial/gender group. Oncologists treating BC patients should be aware of the racial and gender disparity. More research needs to be done to help improve early access to health care amongst female and minority BC patients. [Table: see text]

Urothelial cancer: Impact of gender on stage at diagnosis and survival.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 316-316
Author(s):  
Jeanne Michelle du Manoir ◽  
Suzanne Richter ◽  
Srikala S. Sridhar
Keyword(s):  
Gender Differences ◽  
Overall Survival ◽  
Organ Dysfunction ◽  
Urothelial Cancer ◽  
Smoking Status ◽  
Performance Status ◽  
Stage Iv ◽  
Gender Disparity ◽  
Stage At Diagnosis ◽  
Stage Iv Disease

316 Background: Gender differences for disease course and survival in various cancers exist. Gender disparity for both stage at diagnosis and overall survival (OS) has been observed in urothelial cancer (UC). We report a single institution analysis of UC patients treated with chemotherapy to further investigate gender differences in outcomes. Methods: We identified 198 bladder cancer pts treated with chemotherapy since 2002. Chemotherapy was either given as adjuvant or palliative and the most common regimens used were gemcitabine and cisplatin, gemcitabine and carboplatin or gemcitabine alone. Age and stage at diagnosis, sex, smoking status, radiation exposures, bloodwork as a measure of organ dysfunction and overall survival info was collected. Outcomes were compared using Chi Square Statistic. Results: Age at diagnosis, smoking status and prior pelvic radiation were not significantly different (females 66.1 yrs vs males 63.6 yrs; 54% smokers in both groups; 8.3% females vs 7.6% males exposed to radiation). Significantly more females were diagnosed with advanced disease than men (70.8% vs 58.7%, p=0.049) vs earlier stages (stage 0-I) (12.2% vs 35.9%, p=0.03). For patients deceased, OS was not significantly different between genders when analysed for all stages combined (deceased 41.5 vs 39.9 mos), or for those diagnosed only at Stage IV (deceased 12.4 vs 8.6 mos). Of patients still alive at time of review, a survival advantage was apparent for men at all stages (54.8 vs 38.7 months), as well as with stage IV disease (35.9 vs 19.7 months). Gemcitabine-cisplatin was given more often to men with stage IV disease than females (93% vs 63%, p<0.02) despite no difference in organ dysfunction, or ECOG performance status in females. Conclusions: We observed that while both genders are similar with respect to age at UC diagnosis, risk factors exposures (smoking, radiation) and pathological variants, females were diagnosed at later stages, and receive standard first line therapy less often. Our data suggest that this impacts negatively on OS in females diagnosed in earlier disease stages. Further research is needed to identify if we can improve outcome by promoting earlier diagnosis and more aggressive management in earlier disease in females.

Insurance status and cancer disparities in adolescents and young adults age 15 to 39: National Cancer Data Base, 1998-2003.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6011-6011
Author(s):  
Anthony Robbins ◽  
Catherine C. Lerro ◽  
Ronald Barr
Keyword(s):  
Young Adults ◽  
Independent Predictor ◽  
Stage Iv ◽  
National Sample ◽  
Cancer Disparities ◽  
National Cancer Data Base ◽  
Insurance Status ◽  
Stage At Diagnosis ◽  
Cancer Data ◽  
Strong Independent Predictor

6011 Background: Since the mid-1970s there has been little progress in improving cancer survival for adolescents and young adults (AYAs, defined by the National Cancer Institute as individuals 15 to 39 years of age), in contrast to the substantial improvements for children and older adults. The association between insurance status and cancer disparities (stage at diagnosis, survival, and treatment) in AYA patients has not been examined in a national sample. Methods: The National Cancer Data Base, a national hospital-based cancer registry, was used to examine insurance status and cancer disparities in 177,359 AYA cancer patients. Cases were diagnosed during 1998−2003 and followed for vital status through 2008. We examined the association between insurance status and stage at diagnosis, stage-specific survival, and receipt of the most frequently used stage-specific treatments for common AYA sites (thyroid, female breast, non-Hodgkin lymphoma, and acute myeloid leukemia). Results: Insurance status was strongly related to cancer disparities in AYA patients. For example, compared to patients with private insurance, uninsured patients were 1.71 times more likely to be diagnosed at stage IV (95% confidence interval [CI], 1.63−1.79), had higher risk of death within every stage [stage I, hazard ratio (HR) (95% CI), 2.43 (2.13−2.76); stage II, 1.87 (1.70−2.06); stage III, 1.55 (1.43−1.68); stage IV, 1.39 (1.31−1.48); and unstaged (leukemias, CNS tumors, etc.), 1.67 (1.58−1.76), and for the four sites listed above, were less likely to receive the most frequently used stage-specific treatments. Insurance status remained a strong independent predictor for each of these outcomes in multivariate models adjusting for patient, hospital, and tumor factors. Conclusions: In a large national sample, insurance status was a strong independent predictor of cancer disparities in AYA patients. The Affordable Care Act of 2010 should facilitate the acquisition of adequate health insurance by AYA, who are the most under- and uninsured age group in the US population, and should contribute to remediation of such disparities.

scholarly journals Race-ethnic and gender differences in representation within the English National Health Service: a quantitative analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034258 ◽  
Author(s):  
Adrienne Milner ◽  
Elizabeth Baker ◽  
Samir Jeraj ◽  
Jabeer Butt
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Gender Disparity ◽  
Gender Disparities ◽  
National Study ◽  
Chinese People ◽  
White People ◽  
Service Staff ◽  
And Gender

ObjectivesTo evaluate race-ethnic and gender disparities in National Health Service (NHS) England employment in position, prestige and pay.DesignNational study using data from NHS Digital.SettingTrusts and clinical commissioning groups in England.Participants1 105 390 NHS Hospital and Community Health Service staff.ResultsChinese people (42.9%, 95% CI 41.7% to 44.1%) are the most likely to be employed as doctors, followed by Asians (28.6%, 95% CI 28.3% to 28.8%) and people of mixed race/ethnicity (17.9%, 95% CI 17.3% to 18.4%); while white people (6.8%, 95% CI 6.7% to 6.8%) are less likely to be employed as doctors. However, white doctors are the most likely to be in the highest paid positions: 46.0% (95% CI 45.6% to 46.4%) of white doctors are consultants, whereas only 33.4% (95% CI 31.6% to 35.2%) of Chinese doctors are consultants. Black people are under-represented both among doctors and as consultants: 6.5% (95% CI 6.4% to 6.7%) of black employees are doctors and 30.6% (95% CI 29.2% to 32.0%) of black doctors are consultants. We found similar results for nurses and health visitors, where white people are over-represented in the higher pay bands. However, among support staff for doctors, nurses and midwives, we found that Chinese people were over-represented in the higher pay bands. These race-ethnic differences were similar for women and men. Additionally, we found that men were more likely to be employed in higher pay bands than women, and this gender disparity was apparent across race-ethnic groups.ConclusionsRace-ethnic and gender disparities exist in the NHS in position, prestige and pay. To begin to overcome such disparities, the NHS must collect data using consistent race-ethnic categories in order to examine differences over time.

Racial/ethnic and gender disparities in anger management therapy as a probation condition.

2020 ◽  
Vol 44 (1) ◽  
pp. 88-96 ◽  
Author(s):  
Cassandra A. Bailey ◽  
Betsy E. Galicia ◽  
Kalin Z. Salinas ◽  
Melissa Briones ◽  
Sheila Hugo ◽  
...  
Keyword(s):  
Anger Management ◽  
Gender Disparities ◽  
And Gender ◽  
Racial Ethnic

Determinants, Attitudes and Practices on Child Marriage: Evidences from Rural Rajasthan

2015 ◽  
Vol 4 (1and2) ◽  
Author(s):  
Abdul Azeez E.P. ◽  
Amit Poonia
Keyword(s):  
20Th Century ◽  
Gender Disparity ◽  
Child Marriage ◽  
Girl Child ◽  
Attitudes And Practices ◽  
Number Of Children ◽  
Social Concerns ◽  
And Gender

Rajasthan State is one of the hotspots of child marriages in India. A large number of children especially girl child get married before attaining the legal age and even before the occurrence of physical maturity. The magnitude of the age-old tradition has decreased in many regions in comparison to the last decade of 20th century. But still the diminishment of the child marriage is not promising and it exists as one of the major social concerns. The very existence of child marriage has multifaceted effects on the individuals who victimized for it. The glaring gender disparity and gender biased issues are also one of the products of early marriages.

Health Insurance Status as a Predictor of Mode of Colon Cancer Detection but Not Stage at Diagnosis: Implications for Early Detection

2021 ◽  
pp. 003335492199917
Author(s):  
Lindsey A. Jones ◽  
Katherine C. Brewer ◽  
Leslie R. Carnahan ◽  
Jennifer A. Parsons ◽  
Blase N. Polite ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Health Insurance ◽  
Early Detection ◽  
Late Stage ◽  
Early Stage ◽  
Insurance Status ◽  
Stage At Diagnosis ◽  
Health Insurance Status ◽  
Percentage Point Increase ◽  
Point Increase

Objective For colon cancer patients, one goal of health insurance is to improve access to screening that leads to early detection, early-stage diagnosis, and polyp removal, all of which results in easier treatment and better outcomes. We examined associations among health insurance status, mode of detection (screen detection vs symptomatic presentation), and stage at diagnosis (early vs late) in a diverse sample of patients recently diagnosed with colon cancer from the Chicago metropolitan area. Methods Data came from the Colon Cancer Patterns of Care in Chicago study of racial and socioeconomic disparities in colon cancer screening, diagnosis, and care. We collected data from the medical records of non-Hispanic Black and non-Hispanic White patients aged ≥50 and diagnosed with colon cancer from October 2010 through January 2014 (N = 348). We used logistic regression with marginal standardization to model associations between health insurance status and study outcomes. Results After adjusting for age, race, sex, and socioeconomic status, being continuously insured 5 years before diagnosis and through diagnosis was associated with a 20 (95% CI, 8-33) percentage-point increase in prevalence of screen detection. Screen detection in turn was associated with a 15 (95% CI, 3-27) percentage-point increase in early-stage diagnosis; however, nearly half (47%; n = 54) of the 114 screen-detected patients were still diagnosed at late stage (stage 3 or 4). Health insurance status was not associated with earlier stage at diagnosis. Conclusions For health insurance to effectively shift stage at diagnosis, stronger associations are needed between health insurance and screening-related detection; between screening-related detection and early stage at diagnosis; or both. Findings also highlight the need to better understand factors contributing to late-stage colon cancer diagnosis despite screen detection.

Sign in / Sign up

Export Citation Format

Share Document