Socioeconomic and gender disparities in anal cancer diagnosis and treatment

Celie, Karel-Bart; Jackson, Christopher M.; Agrawal, Surbhi; Dodhia, Chetan; Guzmán, Carlos; Kaufman, Theodor; Hellenthal, Nicholas J.; Monie, Daphne; Monzon, Jose R.; Oceguera, Luis

doi:10.1016/j.suronc.2017.03.008

Cited by 26 publications

(22 citation statements)

References 15 publications

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“…Racial and gender disparities in the incidence of anal cancer: analysis of the Nationwide Inpatient Sample (NIS) smoking, genital or anal warts, anoreceptive intercourse, multiple sex partners, and history of cervical, vulvar, or vaginal cancer (6)(7)(8). Clinical research in AC describes its relationship with income levels and demographic factors, where lower income levels have more severe cases of AC (9)(10)(11). Interestingly, other research suggests that higher levels of education are associated with increased incidence in AC for males and females (12).…”

Section: Original Articlementioning

confidence: 99%

Racial and gender disparities in the incidence of anal cancer: analysis of the Nationwide Inpatient Sample (NIS)

Cruz¹,

Chen²,

Hsu³

et al. 2018

J. Gastrointest. Oncol

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Background: Racial and gender disparities have been shown in other gastrointestinal cancers. However, there is a paucity of data on racial and gender disparities in anal cancer (AC). The aim of this study was to assess racial and gender disparities among patients with AC. Methods: We analyzed data from the National Inpatient Sample (NIS) 2011 database of patients diagnosed with AC with age ≥18. Demographic data including age, race and gender were assessed. Patients were stratified based on race and gender. Log binomial regression was used to generate risk ratios. Results: A total of 6,013,105 patients were assessed and 1,956 (0.03%) patients had AC. Female patients were more at risk of developing AC [relative risk (RR): 1.14, P=0.02]. Whites and Blacks had the highest incidence followed by Asians/Pacific Islanders. Black males had increased risk of AC (RR: 1.43, P<0.01). Amongst Hispanics; both males (RR: 0.69, P=0.05) and females (RR: 0.46, P<0.0001) had decreased risk of developing AC. Finally, we saw that Asian females had a much lower risk of developing AC (RR: 0.33, P<0.01). Conclusions: Racial disparities and gender differences exist in the incidence of AC. Potential causes for this disparity are disparate access to healthcare, lack of education, and lack of awareness. Greater understanding of the racial disparity in AC can help identify at risk population and eventually lead to improved preventative measures to ultimately reduce the incidence of AC.

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Section: Original Articlementioning

confidence: 99%

Racial and gender disparities in the incidence of anal cancer: analysis of the Nationwide Inpatient Sample (NIS)

Cruz¹,

Chen²,

Hsu³

et al. 2018

J. Gastrointest. Oncol

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“…In spite of significant diagnostic and therapeutic medical advances in the modern era, significant disparities in health care persist. For patients with cancer, adverse social and economic factors synergize and result in worse outcomes: disparity leads to earlier recurrence of disease and shorter survival across numerous cancer types . For patients with gastric adenocarcinoma (GAC), these disparities are especially harmful as GAC represents the second leading cause of cancer‐related deaths worldwide .…”

Section: Introductionmentioning

confidence: 99%

Identifying the barriers to gastric cancer care at safety‐net hospitals: A novel comparison of a safety‐net hospital to a neighboring quaternary referral academic center in the same healthcare system

Zaidi

Rappaport

Ethun

et al. 2018

Journal of Surgical Oncology

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Background:The three-delays model describes delays in seeking, reaching, and receiving care for vulnerable populations needing treatment. The dominant delay for patients with gastric adenocarcinoma (GAC) is unknown. We aimed to define patients with GAC who reached and received care at our regional safety-net hospital (Grady Memorial Hospital [GMH]) and our neighboring quaternary referral hospital (Emory University Hospital [EUH]). Methods: Clinicopathologic data from National Cancer Database (NCDB) participating academic centers were compared with GMH from 2004 to 2014. Outcomes of patients undergoing surgery at GMH were compared to those at EUH. Results: At presentation, compared to NCDB centers (n = 69 662), GMH patients (n = 154) were more often black (85.1 vs 17.2%; P < 0.001), uninsured (30.5 vs 4.7%; P < 0.001), have stage IV disease (43.5 vs 30.1%; P = 0.017), and received no treatment (40.3 vs 18.4%; P < 0.001). When only comparing patients who underwent curative-intent resection at GMH (n = 23) to EUH (n = 137), median overall survival was similar between both groups (GMH: median not reached; EUH: 59.8 mos; P = 0.785). Conclusion: Although vulnerable patients with GAC within a safety-net hospital present with later stages of the disease, those who received surgery have acceptable outcomes. Thus, efforts should be made to overcome barriers in seeking care. K E Y W O R D S disparty, gastric cancer, safety-net

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“…However, our point estimates are consistent with those reported in several other studies. 1,2,11,17 Conclusions These data show that although both men and women are developing anal cancer, the incidence in young adult males is climbing. Our data also suggest there are significant sociodemographic differences in anal cancer, wherein communities with a higher proportion of individuals living in poverty and a higher proportion of racial/ethnic minority groups bear the highest incidence of disease.…”

Section: Discussionmentioning

confidence: 75%

“…Various population-level factors (e.g., the prevalence of high-risk HPV types, and sexual mixing patterns in the community) and individual-level factors (e.g., sexual behaviors, access to screening, and treatment) could be directly influencing the individual's risk of developing disease. 11 , 17 Future study is needed to better understand and mitigate the drivers of this spatiotemporal heterogeneity.…”

Section: Discussionmentioning

confidence: 99%

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Disparities in the Epidemiology of Anal Cancer: A Cross-Sectional Time Series

et al. 2020

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Purpose: To assess the trends and sociodemographic disparities of anal cancer. Methods: For this time series, billing claims were reviewed for all encounters between 2007 and 2011 in the Yale New Haven Health System. Results: There were 80 new cases identified. Decreasing trends were seen in women and increasing trend in men (À30.1% and 27.3%). Diagnoses were more common in areas with the highest proportion of racial minorities (incidence rate ratio [IRR] = 1.75; p £ 0.01) and poverty (IRR = 1.72; p = 0.04). Conclusions: Anal cancer continues to rise in men during the postvaccine era. Communities with the highest proportion of poverty and racial/ethnic minority groups bear the highest burden of disease.

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Socioeconomic and gender disparities in anal cancer diagnosis and treatment

Cited by 26 publications

References 15 publications

Racial and gender disparities in the incidence of anal cancer: analysis of the Nationwide Inpatient Sample (NIS)

Racial and gender disparities in the incidence of anal cancer: analysis of the Nationwide Inpatient Sample (NIS)

Identifying the barriers to gastric cancer care at safety‐net hospitals: A novel comparison of a safety‐net hospital to a neighboring quaternary referral academic center in the same healthcare system

Disparities in the Epidemiology of Anal Cancer: A Cross-Sectional Time Series

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