Chan Shen1,2, Dian Gu3, Shouhao Zhou2, Ying Xu3, Amir Mehrvarz Sarshekeh4, Daniel Halperin4, Ya-Chen T Shih3, James C Yao4, Arvind Dasari4. 1. From the Division of Outcomes Research and Quality, Department of Surgery. 2. Department of Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, PA. 3. Departments of Health Services Research. 4. Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Abstract
OBJECTIVES: The incidence of neuroendocrine tumors (NETs) has been steadily increasing. Racial differences in the incidence and survival are mostly unknown. This study examines the racial differences and the underlying causes. METHODS: We conducted a retrospective, population-based study using datasets from Surveillance, Epidemiology, and End Results (SEER) cancer registry and SEER data linked with Medicare claims (SEER-Medicare). We examined the incidence rates and the effects of patient demographics, clinical characteristics, and socioeconomic factors on survival. RESULTS: Of the 15,786 and 1731 cases from SEER and SEER-Medicare, 1991 and 163 were blacks, respectively. We found that blacks had higher NET incidence for all stages, with the largest difference noted in the local stage (4.3 vs 2.6 per 100,000 in whites). We found worse survival for distant-stage black patients, although they more often had clinical factors typically associated with better prognosis in NETs. However, they were also found to have significant unfavorable differences in socioeconomic and sociodemographic factors. CONCLUSIONS: Blacks have higher incidence of NETs and worse survival compared with other races, especially whites. The influences of neighborhood socioeconomic, sociodemographic, and marital status suggest that social determinants, support mechanisms, and access to health care may be contributing factors.
OBJECTIVES: The incidence of neuroendocrine tumors (NETs) has been steadily increasing. Racial differences in the incidence and survival are mostly unknown. This study examines the racial differences and the underlying causes. METHODS: We conducted a retrospective, population-based study using datasets from Surveillance, Epidemiology, and End Results (SEER) cancer registry and SEER data linked with Medicare claims (SEER-Medicare). We examined the incidence rates and the effects of patient demographics, clinical characteristics, and socioeconomic factors on survival. RESULTS: Of the 15,786 and 1731 cases from SEER and SEER-Medicare, 1991 and 163 were blacks, respectively. We found that blacks had higher NET incidence for all stages, with the largest difference noted in the local stage (4.3 vs 2.6 per 100,000 in whites). We found worse survival for distant-stage black patients, although they more often had clinical factors typically associated with better prognosis in NETs. However, they were also found to have significant unfavorable differences in socioeconomic and sociodemographic factors. CONCLUSIONS: Blacks have higher incidence of NETs and worse survival compared with other races, especially whites. The influences of neighborhood socioeconomic, sociodemographic, and marital status suggest that social determinants, support mechanisms, and access to health care may be contributing factors.
Authors: Hilary Chan; Li Zhang; Michael A Choti; Matthew Kulke; James C Yao; Eric K Nakakura; Mark Bloomston; Al B Benson; Manisha H Shah; Jonathan R Strosberg; Emily K Bergsland; Katherine Van Loon Journal: Pancreas Date: 2021-04-01 Impact factor: 3.243