Sex, racial/ethnic and socioeconomic disparities in patients with metastatic bone disease

Abstract

Background: We have analyzed sex, race/ethnicity or socioeconomic disparities in the incidence of metastatic bone disease (MBD).Methods: Patients with the diagnosis of MBD at presentation for five most common primary anatomical sites was extracted from Surveillance, Epidemiology, and EndResults Census tract-level dataset. Mean incidence of MBD for different sex, racial/ ethnic and socioeconomic groups were compared. Results:The five most common anatomical sites with MBD at presentation include "lung: (n = 59 739), "prostate" (n = 19 732), "breast" (n = 16 244), "renal" (n = 7718) and "colon" (n = 3068). There was an increase in incidence of MBD among cancers originating from prostate (annual percentage change [APC] 4.94), renal (APC 2.55), and colon (APC 3.21) (p < 0.05 for all). Non-Hispanic Blacks had higher incidence of MBD for prostate and breast primary sites (p < 0.001). Non-Hispanic American Indian Alaskan Native had higher incidence of MBD for cancers originating from renal (p < 0.001) and colon (p = 0.049). A higher incidence of MBD was seen in lower socioeconomic status (SES) groups for the selected sites (p < 0.001).Conclusions: These findings suggest that there are multiple sex-related, racial/ethnic and SES disparities in the incidence of MBD from the 5 most common primary sites.Higher incidence seen among lower SES suggests delay in diagnosis and limited access to screening modalities.

Socioeconomic and insurance‐related disparities in disease‐specific survival among patients with metastatic bone disease

“…We have recently demonstrated wide-spread socioeconomic disparities in the incidence of MBD. 8 Taken together, the findings should prompt a higher degree of suspicion and screening among at risk strata, to facilitate earlier diagnosis and subsequent earlier access to care. The findings are also important for public health policy.…”

“…Case information was extracted from the NCI's Surveillance Epidemiology End Results (SEER) program as outlined in our recent publication. 1,8 SEER currently collects the data from 22 registries covering approximately 48% of the US population. 1 The presence of For our analysis, we grouped primary malignancies originating from "trachea and bronchus" with primary malignancies originating from "lung and pleura."…”

“…1 We have recently highlighted disparities in incidence of MBD for the five most common primary sites. 8 In the present investigation, we were interested in assessing disparities in survival for patients with MBD, given that bone is one of the most common sites of metastatic disease 5,8,9 and also that metastatic disease is the most common malignant process affecting the skeletal system 4,10 Patients with MBD have advanced systemic disease and face unique treatment challenges. 6,11,12 MBD is associated with significant morbidity and functional compromise.…”

“…[16][17][18][19][20] Considering the disproportionately higher costs associated with the care of patients afflicted with MBD as well as the observed improvement in life expectancy, we examined the relationship between the socioeconomic and insurance-related disparities and DSS of patients with MBD from the five most common sites. 8…”

“…In the context of cancer, disparities in the incidence, prevalence, rate of screening, stage at initial presentation, morbidity, survival, and financial burden of disease have been reported for multiple primary malignanices 1 . We have recently highlighted disparities in incidence of MBD for the five most common primary sites 8 . In the present investigation, we were interested in assessing disparities in survival for patients with MBD, given that bone is one of the most common sites of metastatic disease 5,8,9 and also that metastatic disease is the most common malignant process affecting the skeletal system 4,10 …”