BACKGROUND: To the authors' knowledge, it remains unknown whether race-based differences in cancer outcomes have changed with time. In the current study, the authors assessed whether racial disparities in cancer-specific mortality have improved over the last 20 years. METHODS: The Surveillance, Epidemiology, and End Results program was used to identify 2,713,474 patients diagnosed between 1988 and 2007 with either lung, breast, prostate, or colorectal cancer (the leading 3 causes of cancer-related mortality among each sex). After exclusions, 1,001,978 patients remained eligible for analysis. The impact of race on cancer-specific mortality was assessed using the regression model of Fine and Gray; an interaction model evaluated trends over time. RESULTS: African Americans presented with a more advanced stage of disease (P < .001) and underwent definitive therapy less often (P < .001) than whites. After adjustment for demographics and year of diagnosis, African Americans were found to have higher estimates of cancer-specific mortality than whites for all cancers combined (hazards ratio, 1.28; 95% confidence interval, 1.26-1.30 [P < .001]) and within each individual cancer (each P < .05). These differences did not change significantly between 1988 through 1997 and 1998 through 2007, except among patients with breast cancer, in whom survival disparities increased. These findings remained significant after adjustment for stage of disease at presentation and receipt of definitive therapy (hazards ratio for breast cancer mortality in African Americans vs whites: 1.37 from 1988-1997 and 1.53 from 1998-2007; P for interaction, < .001). CONCLUSIONS: The survival gap for African Americans has not closed over time. Race-based differences in outcome persist independent of stage of disease and treatment, suggesting that additional strategies beyond screening and improving access to care, such as further research into tumor biologies disproportionately affecting African Americans, are needed to improve survival for African American patients with cancer.
BACKGROUND: To the authors' knowledge, it remains unknown whether race-based differences in cancer outcomes have changed with time. In the current study, the authors assessed whether racial disparities in cancer-specific mortality have improved over the last 20 years. METHODS: The Surveillance, Epidemiology, and End Results program was used to identify 2,713,474 patients diagnosed between 1988 and 2007 with either lung, breast, prostate, or colorectal cancer (the leading 3 causes of cancer-related mortality among each sex). After exclusions, 1,001,978 patients remained eligible for analysis. The impact of race on cancer-specific mortality was assessed using the regression model of Fine and Gray; an interaction model evaluated trends over time. RESULTS: African Americans presented with a more advanced stage of disease (P < .001) and underwent definitive therapy less often (P < .001) than whites. After adjustment for demographics and year of diagnosis, African Americans were found to have higher estimates of cancer-specific mortality than whites for all cancers combined (hazards ratio, 1.28; 95% confidence interval, 1.26-1.30 [P < .001]) and within each individual cancer (each P < .05). These differences did not change significantly between 1988 through 1997 and 1998 through 2007, except among patients with breast cancer, in whom survival disparities increased. These findings remained significant after adjustment for stage of disease at presentation and receipt of definitive therapy (hazards ratio for breast cancer mortality in African Americans vs whites: 1.37 from 1988-1997 and 1.53 from 1998-2007; P for interaction, < .001). CONCLUSIONS: The survival gap for African Americans has not closed over time. Race-based differences in outcome persist independent of stage of disease and treatment, suggesting that additional strategies beyond screening and improving access to care, such as further research into tumor biologies disproportionately affecting African Americans, are needed to improve survival for African American patients with cancer.
Authors: Danielle S Bitterman; David Grew; Ping Gu; Richard F Cohen; Nicholas J Sanfilippo; Cynthia G Leichman; Lawrence P Leichman; Harvey G Moore; Heather T Gold; Kevin L Du Journal: J Gastrointest Oncol Date: 2015-10
Authors: Catherine Duggan; Jean de Dieu Tapsoba; Caitlin Mason; Ikuyo Imayama; Larissa Korde; Ching-Yun Wang; Anne McTiernan Journal: Cancer Prev Res (Phila) Date: 2015-04-23
Authors: Susan Halabi; Sandipan Dutta; Catherine M Tangen; Mark Rosenthal; Daniel P Petrylak; Ian M Thompson; Kim N Chi; John C Araujo; Christopher Logothetis; David I Quinn; Karim Fizazi; Michael J Morris; Mario A Eisenberger; Daniel J George; Johann S De Bono; Celestia S Higano; Ian F Tannock; Eric J Small; William Kevin Kelly Journal: J Clin Oncol Date: 2018-12-21 Impact factor: 44.544
Authors: Carissa C Jones; Sarah Fletcher Mercaldo; Jeffrey D Blume; Angela S Wenzlaff; Ann G Schwartz; Heidi Chen; Stephen A Deppen; William S Bush; Dana C Crawford; Stephen J Chanock; William J Blot; Eric L Grogan; Melinda C Aldrich Journal: J Thorac Oncol Date: 2018-06-06 Impact factor: 15.609
Authors: Elie K Mehanna; Paul J Catalano; Daniel N Cagney; Daphne A Haas-Kogan; Brian M Alexander; James A Tulsky; Ayal A Aizer Journal: J Natl Cancer Inst Date: 2020-12-14 Impact factor: 13.506
Authors: Niharika Dixit; Gregory B Crawford; Manon Lemonde; Cynthia N Rittenberg; Paz Fernández-Ortega Journal: Support Care Cancer Date: 2016-04-06 Impact factor: 3.603
Authors: Craig Evan Pollack; Katrina A Armstrong; Nandita Mitra; Xinwei Chen; Katelyn R Ward; Archana Radhakrishnan; Michelle S Wong; Justin E Bekelman; Charles C Branas; Karin V Rhodes; David T Grande Journal: Cancer Date: 2017-07-20 Impact factor: 6.860
Authors: Stephen R Grant; Gary V Walker; B Ashleigh Guadagnolo; Matthew Koshy; Pamela K Allen; Usama Mahmood Journal: Cancer Date: 2015-04-27 Impact factor: 6.860
Authors: Jennifer L Beebe-Dimmer; Terrance L Albrecht; Tara E Baird; Julie J Ruterbusch; Theresa Hastert; Felicity W K Harper; Michael S Simon; Judith Abrams; Kendra L Schwartz; Ann G Schwartz Journal: Cancer Epidemiol Biomarkers Prev Date: 2018-11-27 Impact factor: 4.254