Surviving rectal cancer: examination of racial disparities surrounding access to care

Daly, Meghan C.; Jung, Andrew; Hanseman, Dennis J.; Shah, Shimul A.; Paquette, Ian M.

doi:10.1016/j.jss.2016.12.015

Cited by 11 publications

(11 citation statements)

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“…Although not statistically significant, Black patients also trended toward a lower likelihood of having a locally staged tumor at diagnosis. This factor has been observed in other cancers, including, for example, colorectal cancer and prostate cancer, where screening guidelines are definitive and universal 18–20 . Disparities in access to care may also explain why the CDSS for Black and American Indian/Alaskan Native patients does not converge to the same high level as for other races.…”

Section: Discussionmentioning

confidence: 98%

“…This factor has been observed in other cancers, including, for example, colorectal cancer and prostate cancer, where screening guidelines are definitive and universal. [18][19][20] Disparities in access to care may also explain why the CDSS for Black and American Indian/Alaskan Native patients does not converge to the same high level as for other races. Such disparities may be particularly important for cancers as rare as paranasal sinus tumors, as the need for highly subspecialized care is augmented and can exacerbate underlying issues involving access care.…”

Section: Discussionmentioning

confidence: 99%

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Racial and ethnic disparities in paranasal sinus malignancies

Sharma

Schlosser

Beswick

et al. 2021

Int Forum Allergy Rhinol

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Background: Racial and ethnic disparities in cancer outcomes have been demonstrated for several different malignancies. In this study we aimed to quantify disease-specific survival (DSS) and the 5-year conditional disease-specific survival (CDSS, the change in life expectancy with increasing survivorship) for paranasal sinus cancer by race and ethnicity. Methods: Patients with sinus cancer between 1973 and 2015 were extracted from the Surveillance, Epidemiology, End Results (SEER) registry. Kaplan-Meier analysis for DSS was stratified by race and ethnicity. Cox regression models of DSS were generated controlling for stage, age, race, and ethnicity. CDSS was calculated using Cox models. Logistic regression was conducted to identify risk factors for younger age at diagnosis, late-stage at diagnosis, and likelihood of receiving surgical intervention when recommended. Results:The analysis included a total of 5202 patients. DSS was significantly different when stratified by race (p < 0.01). Compared with White patients, Black patients (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.13-1.45; p < 0.001) and American Indian/Alaskan Natives (HR, 1.94; 95% CI, 1.37-2.74, p < 0.001) exhibited increased mortality when controlling for other factors.Black patients had worse CDSS for regional and distant staged cancer compared with other races; American Indian/Alaskan Native patients had worse CDSS for cancers of all stages. Hispanic patients were more likely to present with advanced disease (odds ratio [OR], 1.47; 95% CI, 1.07-2.07; p = 0.020). American Indian/Alaskan Native patients were less likely than White patients to receive surgical intervention when recommended (OR, 0.42; 95% CI, 0.21-0.04; p = 0.024). Nonwhite patients were more likely to be diagnosed at a younger age.Variations in racial and ethnic disparities were observed over time. Conclusion: Race and ethnicity significantly impact paranasal sinus cancer outcome metrics. Disparities in outcomes are likely multifactorial.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Racial and ethnic disparities in paranasal sinus malignancies

Sharma

Schlosser

Beswick

et al. 2021

Int Forum Allergy Rhinol

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“…Racial disparities and access to medical care have been increasingly recognized as having a direct impact on disease presentation [20][21][22]. Furthermore, patients undergoing colorectal surgery requiring an ostomy typically use more health care resources and have the potential for more postoperative complications [23,24].…”

Section: Discussionmentioning

confidence: 99%

Racial disparities after stoma construction in colorectal surgery

et al. 2020

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Aim Racial disparities are under‐recognized among patients undergoing colorectal surgery. The purpose of this study was to determine the complication rates and surgical outcomes stratified by race and ethnicity among patients undergoing colorectal surgery with intestinal stoma creation. Method The ACS NSQIP database from 2013 to 2016 was used. Colon, rectum and small bowel cases requiring intestinal stoma creation were selected. Both African‐American and other groups of minority patients were compared with Caucasian patients using a complex multivariable analysis model. Primary outcomes of interest were complication rates, mortality and extended hospital length of stay. Results The study included 38 088 admissions. After multivariable analysis, African‐American patients still had a prolonged length of hospital stay and higher complication rates. Other minorities also had a prolonged length of hospital stay and higher complication rates. Conclusions Both African‐American and other groups of minority patients requiring an ostomy suffer significantly higher postoperative complication rates and a prolonged hospital length of stay, even after comorbidity adjustment. Access to care, socioeconomic status and comorbid disease management are all important factors for minority patients who undergo colorectal surgery requiring intestinal stoma construction.

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“…Racial, ethnic, and socioeconomic disparities influence outcomes for many cancers. 1 - 10 Studies have consistently demonstrated decreased survival for solid tumors as well as hematologic malignancies among patients of certain racial and socioeconomic backgrounds. 11 , 12 Mechanisms underlying these disparities include differences in access to care and follow-up, screening utilization, and health behaviors.…”

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confidence: 99%

Association of Race, Ethnicity, and Socioeconomic Status With Esthesioneuroblastoma Presentation, Treatment, and Survival

et al. 2022

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Objective Socioeconomic and other demographic factors are associated with outcomes in head and neck cancer. This study uses a national cancer database to explore how patient race, ethnicity, and socioeconomic status (SES) are associated with esthesioneuroblastoma outcomes, including 5-year disease-specific survival (DSS), conditional DSS, stage at diagnosis, and treatment. Study Design Retrospective cohort analysis. Setting Patients with esthesioneuroblastomas between 1973 and 2015 from the SEER registry (Surveillance, Epidemiology, and End Results). Methods The National Cancer Institute Yost Index, a census tract–level composite score composed of 7 parameters, was used to categorize the SES of patients. Kaplan-Meier analysis and Cox regression were conducted to assess DSS. Conditional DSS was calculated per estimates from simplified Cox models. Logistic regression was conducted to identify risk factors for advanced cancer stage at diagnosis and the likelihood of receiving multimodal therapy. Results Complete data were included for 561 patients. DSS was significantly associated with SES (log-rank, P < .01) but not race. According to Cox regression, DSS was worse for the lowest SES tertile vs the highest (hazard ratio, 1.70 [95% CI, 1.05-2.75]; P = .03). Patients of the lowest SES tertile exhibited an increased risk of advanced cancer stage at diagnosis as compared with the highest SES tertile (odds ratio, 1.84 [95% CI, 1.06-3.30]; P = .035). Black patients (odds ratio, 0.44 [95% CI, 0.24-0.84]; P = .011) were less likely than other patients to receive multimodal therapy. SES alone was not associated with receiving multimodal therapy. Conclusion SES is significantly associated with DSS and conditional DSS for patients with esthesioneuroblastomas. Inequalities in access to care and treatment likely contribute to these disparities.

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Surviving rectal cancer: examination of racial disparities surrounding access to care

Cited by 11 publications

References 50 publications

Racial and ethnic disparities in paranasal sinus malignancies

Racial and ethnic disparities in paranasal sinus malignancies

Racial disparities after stoma construction in colorectal surgery

Association of Race, Ethnicity, and Socioeconomic Status With Esthesioneuroblastoma Presentation, Treatment, and Survival

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