دورية أكاديمية
Evaluating Disparities in Colon Cancer Survival in American Indian/Alaskan Native Patients Using the National Cancer Database.
| العنوان: | Evaluating Disparities in Colon Cancer Survival in American Indian/Alaskan Native Patients Using the National Cancer Database. |
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| المؤلفون: | Nalluri H; Department of Surgery, University of Minnesota, Minneapolis, MN, USA., Marmor S; Department of Surgery, University of Minnesota, Minneapolis, MN, USA., Prathibha S; Department of Surgery, University of Minnesota, Minneapolis, MN, USA., Jenkins A; Department of Surgery, University of Minnesota, Minneapolis, MN, USA., Dindinger-Hill K; Department of Surgery, University of Minnesota, Minneapolis, MN, USA., Kihara M; Department of Surgery, University of Minnesota, Minneapolis, MN, USA., Sundberg MA; Department of Medicine, University of Minnesota, Minneapolis, MN, USA.; Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA., Day LW; Division of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, CA, USA., Owen MJ; Department of Family Medicine and BioBehavioral Health, University of Minnesota, Duluth, MN, USA.; Center for American Indian and Minority Health, University of Minnesota, Duluth, MN, USA., Lowry AC; Department of Surgery, University of Minnesota, Minneapolis, MN, USA., Tuttle TM; Department of Surgery, University of Minnesota, Minneapolis, MN, USA. tuttl006@umn.edu. |
| المصدر: | Journal of racial and ethnic health disparities [J Racial Ethn Health Disparities] 2024 Aug; Vol. 11 (4), pp. 2407-2415. Date of Electronic Publication: 2023 Jul 11. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer International Publishing Country of Publication: Switzerland NLM ID: 101628476 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2196-8837 (Electronic) Linking ISSN: 21968837 NLM ISO Abbreviation: J Racial Ethn Health Disparities Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [Cham] : Springer International Publishing |
| مواضيع طبية MeSH: | Colonic Neoplasms*/mortality , Colonic Neoplasms*/ethnology , Colonic Neoplasms*/therapy , Alaska Natives*/statistics & numerical data , Databases, Factual*, Humans ; Male ; Female ; Middle Aged ; Aged ; United States/epidemiology ; Indians, North American/statistics & numerical data ; Adult ; Health Status Disparities ; Aged, 80 and over ; Neoplasm Staging ; White People/statistics & numerical data ; Kaplan-Meier Estimate |
| مستخلص: | Background: Studies demonstrate higher mortality rates from colon cancer in American Indian/Alaskan Native (AI/AN) patients compared to non-Hispanic White (nHW). We aim to identify factors that contribute to survival disparities. Methods: We used the National Cancer Database to identify AI/AN (n = 2127) and nHW (n = 527,045) patients with stage I-IV colon cancer from 2004 to 2016. Overall survival among stage I-IV colon cancer patients was estimated by Kaplan-Meier analysis; Cox proportional hazard ratios were used to identify independent predictors of survival. Results: AI/AN patients with stage I-III disease had significantly shorter median survival than nHW (73 vs 77 months, respectively; p < 0.001); there were no differences in survival for stage IV. Adjusted analyses demonstrated that AI/AN race was an independent predictor of higher overall mortality compared to nHW (HR 1.19, 95% CI 1.01-1.33, p = 0.002). Importantly, compared to nHW, AI/AN were younger, had more comorbidities, had greater rurality, had more left-sided colon cancers, had higher stage but lower grade tumors, were less frequently treated at an academic facility, were more likely to experience a delay in initiation of chemotherapy, and were less likely to receive adjuvant chemotherapy for stage III disease. We found no differences in sex, receipt of surgery, or adequacy of lymph node dissection. Conclusion: We found patient, tumor, and treatment factors that potentially contribute to worse survival rates observed in AI/AN colon cancer patients. Limitations include the heterogeneity of AI/AN patients and the use of overall survival as an endpoint. Additional studies are needed to implement strategies to eliminate disparities. (© 2023. W. Montague Cobb-NMA Health Institute.) |
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| فهرسة مساهمة: | Keywords: American Indian/Alaskan Native; Colorectal cancer; Health equity; Racial disparities |
| تواريخ الأحداث: | Date Created: 20230711 Date Completed: 20240710 Latest Revision: 20240710 |
| رمز التحديث: | 20240711 |
| DOI: | 10.1007/s40615-023-01706-2 |
| PMID: | 37432562 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 2196-8837 |
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| DOI: | 10.1007/s40615-023-01706-2 |