Disparities in cancer diagnosis and survival

Bradley, Cathy J.; Given, Charles W.; Roberts, Caralee

doi:10.1002/1097-0142(20010101)91:1<178::aid-cncr23>3.0.co;2-s

Cited by 233 publications

(175 citation statements)

References 23 publications

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“…In striking contrast to studies that demonstrated an association between nonwhite race and inferior cancer care and, ultimately, unfavorable long-term survival, [14][15][16][17][18][19][20][21] we observed that nonwhite race predicted improved surgical care, as defined by adequate lymph node evaluation. Because African Americans and Hispanics tend to be uninsured and of lower socioeconomic status, it is possible that university centers are the likely providers of their surgical care: These findings are contrary to popular opinion.…”

Section: Discussioncontrasting

confidence: 99%

Variations in gastric cancer care

Al‐Refaie

Virnig

Tseng

et al. 2009

Cancer

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BACKGROUND:Race is associated with patterns of presentation and survival outcomes of gastric cancer in the United States. However, the impact of race on the receipt of guideline‐recommended care is not well characterized. By using current recommendations, the authors examined the association between race and guideline‐recommended treatments and identified factors that are predictive of variations in gastric cancer care.METHODS:By using the National Cancer Database for 1998 through 2005, 106,002 patients with gastric adenocarcinoma were identified. Multivariate analysis techniques were used to examine the association between race, the receipt of guideline‐recommended care, and survival after adjusting for covariates.RESULTS:Although African‐American and Hispanic patients were more likely to undergo adequate lymphadenectomy (≥15 lymph nodes) and to receive care at comprehensive cancer centers and high‐volume facilities (for all, P ≤ .001), they were less likely to receive adjuvant multimodality therapy for American Joint Committee on Cancer stage IB through IV, lymph node‐negative (M0) disease. Up to 60% of all patients who underwent gastrectomy failed to receive adequate lymphadenectomy and adjuvant multimodality therapy. The delivery of multimodality therapy varied significantly by stage and lymph node evaluation (P ≤ .001). These findings persisted on our multivariate analyses, indicating that African‐American and Hispanic patients received adequate lymph node evaluation (P ≤ .001), whereas they were associated with receiving no adjuvant multimodality therapy (P ≤ .025).CONCLUSIONS:There were significant variations in treatment for gastric cancer among ethnic groups in the United States. It was noteworthy that, although nonwhite race was associated with improved surgical care, gastric cancer care remained suboptimal overall. Cancer programs need to identify procedures to maximize the delivery of adequate gastric cancer care to all patients. Cancer 2010. © 2010 American Cancer Society.

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Section: Discussioncontrasting

confidence: 99%

Variations in gastric cancer care

Al‐Refaie

Virnig

Tseng

et al. 2009

Cancer

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“…These factors include a low income, Medicaid enrollment, lack of private health insurance, poor transportation, beliefs that women who have breast surgery are no longer attractive to men, beliefs that air causes a cancer to spread, beliefs that chiropractic is effective treatment for breast cancer. 46,47 …”

Section: Socioeconomic Cultural and Behavioral Factorsmentioning

confidence: 99%

Breast cancer among young African-American women

Swanson

Haslam

Azzouz

2002

Cancer

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BACKGROUND.African-American women younger than age 45 years have a higher risk of incidence and mortality due to breast cancer than other women. The reason for this disparity in risk is not well understood. METHODS.This review summarizes the literature on the topic of breast cancer in young women and presents a summary of a discussion on this topic during a national forum on breast cancer among African-American women. RESULTS.The occurrence of breast cancer among African-American women younger than the age of 45 years has not been well studied. There is a clear and long-term pattern of higher incidence and mortality and poorer survival in this population subgroup. CONCLUSION.Research is needed to understand the reasons for these disparities and to reduce or eliminate them. Studies focused on hormonal factors, genetic factors, diet and obesity, and timely access to state-of-the-art prevention, information, screening, diagnosis, and treatment are likely to produce important new knowledge in this area. Cancer 2003;97(1 Suppl):273-9.

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“…[1][2][3][4][5][6][7] Several reasons have been suggested, including socieoeconomic and cultural factors, cancer biology, differential treatment intensity, pharmacogenetics and comorbid conditions. [8][9][10][11][12] Data from hematologic malignancies such as AML also demonstrate poorer survival and worse CR rates in African Americans, specifically men, compared with African American women and whites. 13 A subsequent study did not find any significant differences in the type or intensity of post-remission therapy after AML induction.…”

Section: Introductionmentioning

confidence: 99%

Racial differences in allogeneic hematopoietic cell transplantation outcomes among African Americans and whites

Hamilton

Rybicki

Sekeres

et al. 2015

Bone Marrow Transplant

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The impact of race on outcome has been identified in a number of cancers, with African Americans having poorer survival compared with whites. We conducted a study to investigate the association of race with allogeneic hematopoietic cell transplant (HCT) outcomes. We identified 789 patients (58 African Americans and 731 whites) who underwent allogeneic HCT for hematologic disorders. There were no significant differences between African Americans and white patients in gender, performance status or comorbidity score. However, African Americans were younger than whites (median 40 years versus 47 years, P = 0.003) and were more likely to be in remission at HCT (74% versus 57%, P = 0.011), to have an HLA-mismatched donor (36% versus 14%, P o 0.001), to have positive donor or recipient CMV serostatus (90% versus 69%, P o 0.001) and to have received a cord blood transplant (21% versus 6%, Po 0.001). In univariate analysis, African Americans had worse overall survival (OS) (HR 1.41, P = 0.026) compared with whites, with no significant differences in acute or chronic GvHD, non-CMV infection or relapse. However, after adjusting for several transplant and disease-related factors in multivariate analysis, the OS difference between African Americans and whites became nonsignificant (HR 1.27, P = 0.18). These results suggest that race in and of itself does not lead to worse survival post HCT.

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Disparities in cancer diagnosis and survival

Cited by 233 publications

References 23 publications

Variations in gastric cancer care

Variations in gastric cancer care

Breast cancer among young African-American women

Racial differences in allogeneic hematopoietic cell transplantation outcomes among African Americans and whites

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