Unstaged cancer in the United States: a population-based study

Merrill, Ray M.; Sloan, Arielle; Anderson, Allison E.; Ryker, Karem

doi:10.1186/1471-2407-11-402

Cited by 47 publications

(54 citation statements)

References 24 publications

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“…This study also found higher prevalence of blacks with unstaged cancers or cancers with missing stage at diagnosis for the four main cancer types compared with whites, as suggested by results from previous studies (42–44). For example, Klasen and colleagues (43) found that patient characteristics of being older and black increased the likelihood of having unstaged/missing data.…”

Section: Discussionsupporting

confidence: 88%

White–Black Differences in Cancer Incidence, Stage at Diagnosis, and Survival among Adults Aged 85 Years and Older in the United States

Krok‐Schoen

Baltic

Paskett

2016

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Increased life expectancy, growth of minority populations, and advances in cancer screening and treatment have resulted in an increasing number of older, racially diverse cancer survivors. Potential black/white disparities in cancer incidence, stage, and survival among the oldest old (≥85 years) were examined using data from the SEER Program of the National Cancer Institute. Methods Differences in cancer incidence and stage at diagnosis were examined for cases diagnosed within the most recent 5-year period, and changes in these differences over time were examined for white and black cases aged ≥85 years. Five-year relative cancer survival rate was also examined by race. Results Among those aged ≥85 years, black men had higher colorectal, lung and bronchus, and prostate cancer incidence rates than white men, respectively. From 1973 to 2012, lung and bronchus and female breast cancer incidence increased, while colorectal and prostate cancer incidence decreased among this population. Blacks had higher rates of unstaged cancer compared with whites. The 5-year relative survival rate for all invasive cancers combined was higher for whites than blacks. Notably, whites had more than three times the relative survival rate of lung and bronchus cancer when diagnosed at localized (35.1% vs. 11.6%) and regional (12.2% vs. 3.2%) stages than blacks, respectively. Conclusions White and black differences in cancer incidence, stage, and survival exist in the ≥85 population. Impact Continued efforts are needed to reduce white and black differences in cancer prevention and treatment among the ≥85 population.

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Section: Discussionsupporting

confidence: 88%

White–Black Differences in Cancer Incidence, Stage at Diagnosis, and Survival among Adults Aged 85 Years and Older in the United States

Krok‐Schoen

Baltic

Paskett

2016

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…There is some evidence that unstaged diagnoses in the U.S. are more prevalent with lethal cancers and in certain patient groups including the elderly. [47] However, we were unable to evaluate this within the context of the present report. The influence of access to treatment on cancer outcome could not be evaluated as information on medical insurance coverage was not available from registry data in Guam and Hawaii.…”

Section: Discussionmentioning

confidence: 63%

Cancer in Guam and Hawaii: A comparison of two U.S. Island populations

Hernandez

Bordallo

Green

et al. 2017

Cancer Epidemiology

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Background Cancer disparities within and across populations provide insight into the influence of lifestyle, environment, and genetic factors on cancer risk. Methods Guam cancer incidence and mortality were compared to that of Hawaii using data from their respective population-based, central cancer registries. Results In 2009-2013, overall cancer incidence was substantially lower in Guam than in Hawaii for both sexes while overall cancer mortality was higher for Guam males. Cervical cancer incidence and prostate cancer mortality were higher in Guam. Both incidence and mortality were higher among Guam men for cancers of the lung & bronchus, liver & intrahepatic bile duct, and nasopharynx; Chamorro men were disproportionately affected by these cancers. Filipinos and Whites in Guam had lower overall cancer incidence compared to Filipinos and Whites in Hawaii. Although breast cancer incidence was significantly lower in Guam compared to Hawaii, women in Guam presented at younger ages and with rarer disease histologies such as inflammatory carcinoma were more prevalent. Guam patients were also diagnosed at younger ages for cancers of bladder, pancreas, colon & rectum, liver & intrahepatic bile duct, lung & bronchus, stomach, non-Hodgkin lymphoma, and leukemia. Conclusion Smoking, infectious agents, and betel nut chewing appear to be important contributors to the burden of cancer in Guam. Earlier onset of cancer in Guam suggests earlier age of exposure to key risk factors and/or a more aggressive pathogenesis. Contrasting cancer patterns within Guam and between Guam and Hawaii underscore the potential influence of genes, lifestyle, and environmental factors on cancer development and progression.

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“…These findings suggest that advancing age and the presence of comorbidities were associated with more conservative treatment with less complete diagnostic assessment, which is then associated with ‘unknown’ stage 36 7 Among the group of patients who received prostate procedures other than RP and had a hospital-reported prostate cancer diagnosis within 4 months of the initial diagnosis, those who were older at diagnosis, lived in socioeconomically disadvantaged areas, had prostate procedures other than multiple procedures plus imaging, who were admitted to private hospitals, or who had a day-only admission were more likely to have ‘unknown’ stage recorded in the NSWCR.…”

Section: Discussionmentioning

confidence: 99%

Cancer-related hospitalisations and ‘unknown’ stage prostate cancer: a population-based record linkage study

Luo

Smith

et al. 2017

BMJ Open

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ObjectivesTo identify reasons for prostate cancer stage being recorded as ‘unknown’ in Australia's largest population-based cancer registry.DesignProspective population-based cohort.SettingNew South Wales (NSW) is the most populous state in Australia, with almost one third of the total national population.ParticipantsNSW Cancer Registry (NSWCR) records for prostate cancer cases diagnosed in 2001–2009 were linked to the NSW Admitted Patient Data Collection (APDC) for 2000–2010. All patients in this study had a minimum of 12 months follow-up in the hospital episode records after their date of diagnosis as recorded by the NSWCR.Main outcome measuresIncidence of ‘unknown’ stage prostate cancer and cancer-specific survival.ResultsOf 50 597 prostate cancer cases, 39.9% were recorded as having ‘unknown’ stage. Up to 4 months after diagnosis, 77.2% of cases without a hospital-reported cancer diagnosis were recorded as having ‘unknown’ stage. Among those patients with a hospital-reported cancer diagnosis, stage was ‘unknown’ for 7.6% of cases who received a radical prostatectomy (RP) and for 34.0% of cases who had procedures other than RP. In the latter group, the factors that were related to having ‘unknown’ stage were living in disadvantaged areas (adjusted OR (aOR) range: 1.13 to 1.20), attending a private hospital (aOR range: 1.25 to 2.13), having day-only admission for care (aOR=1.23, 95% CI 1.11 to 1.36), or having procedures other than multiple procedures with imaging (eg, biopsy only, aOR range: 1.11 to 1.45).ConclusionsOver half of ‘unknown’ stage prostate cancer cases did not have a hospital-reported prostate cancer diagnosis within the 4 months after initial diagnosis. We identified differences in the likelihood of cases being recorded as ‘unknown’ stage based on socioeconomic status and facility type, which suggests that further investigation of reporting practices in relation to diagnostic and treatment pathways is required.

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Unstaged cancer in the United States: a population-based study

Cited by 47 publications

References 24 publications

White–Black Differences in Cancer Incidence, Stage at Diagnosis, and Survival among Adults Aged 85 Years and Older in the United States

White–Black Differences in Cancer Incidence, Stage at Diagnosis, and Survival among Adults Aged 85 Years and Older in the United States

Cancer in Guam and Hawaii: A comparison of two U.S. Island populations

Cancer-related hospitalisations and ‘unknown’ stage prostate cancer: a population-based record linkage study

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