دورية أكاديمية
Survival disparities in non-Hispanic Black and White cervical cancer patients vary by histology and are largely explained by modifiable factors.
| العنوان: | Survival disparities in non-Hispanic Black and White cervical cancer patients vary by histology and are largely explained by modifiable factors. |
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| المؤلفون: | Kucera CW; Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA., Chappell NP; George Washington Medical Faculty Associates, George Washington Cancer Center, Washington, DC, USA., Tian C; Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; The Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA., Richardson MT; Department of Obstetrics and Gynecology, University of California, Los Angeles School of Medicine, Los Angeles, CA. USA., Tarney CM; Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA., Hamilton CA; Gynecologic Oncology Section, Women's Services and The Ochsner Cancer Institute, Ochsner Health, New Orleans, LA, USA., Chan JK; Palo Alto Medical Foundation / California Pacific Medical Center /Sutter Health, San Francisco, CA, USA., Kapp DS; Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA., Leath CA 3rd; Division of Gynecologic Oncology, University of Alabama at Birmingham, O'Neal Comprehensive Cancer Center, Birmingham, AL, USA., Casablanca Y; Division of Gynecologic Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA., Rojas C; Division of Gynecologic Oncology, Naval Medical Center Portsmouth, Portsmouth, VA, USA., Sitler CA; Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA., Wenzel L; School of Medicine, University of California Irvine, Irvine, CA, USA., Klopp A; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Jones NL; Division of Gynecologic Oncology, Mitchell Cancer Institute, University of South Alabama, Mobile, AL, USA., Rocconi RP; Division of Gynecologic Oncology, Cancer Center & Research Institute, the University of Mississippi Medical Center, Jackson, MS, USA., Farley JH; Division of Gynecologic Oncology, Center for Women's Health, Cancer Institute, Dignity Health St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA., O'Connor TD; Institute for Genome Sciences, Department of Medicine and Program in Personalized and Genomic Medicine, and Program in Health Equity and Population Health, University of Maryland School of Medicine, Baltimore, MD, USA; University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA., Shriver CD; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA., Bateman NW; Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; The Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA., Conrads TP; Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Women's Health Integrated Research Center, Inova Women's Service Line, Inova Health System, Falls Church, VA, USA., Phippen NT; Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA., Maxwell GL; Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Women's Health Integrated Research Center, Inova Women's Service Line, Inova Health System, Falls Church, VA, USA., Darcy KM; Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; The Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA. Electronic address: darcyk@whirc.org. |
| المصدر: | Gynecologic oncology [Gynecol Oncol] 2024 May; Vol. 184, pp. 224-235. Date of Electronic Publication: 2024 Feb 10. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Academic Press Country of Publication: United States NLM ID: 0365304 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1095-6859 (Electronic) Linking ISSN: 00908258 NLM ISO Abbreviation: Gynecol Oncol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York, Academic Press. |
| مواضيع طبية MeSH: | Uterine Cervical Neoplasms*/pathology , Uterine Cervical Neoplasms*/ethnology , Uterine Cervical Neoplasms*/mortality , White People*/statistics & numerical data , Black or African American*/statistics & numerical data , Carcinoma, Squamous Cell*/pathology , Carcinoma, Squamous Cell*/ethnology , Carcinoma, Squamous Cell*/mortality, Humans ; Female ; Middle Aged ; Aged ; Adult ; Adenocarcinoma/pathology ; Adenocarcinoma/ethnology ; Adenocarcinoma/mortality ; United States/epidemiology ; Healthcare Disparities/ethnology ; Healthcare Disparities/statistics & numerical data ; Health Status Disparities ; Socioeconomic Factors ; Proportional Hazards Models ; Neoplasm Staging |
| مستخلص: | Purpose: We investigated racial disparities in survival by histology in cervical cancer and examined the factors contributing to these disparities. Methods: Non-Hispanic Black and non-Hispanic White (hereafter known as Black and White) patients with stage I-IV cervical carcinoma diagnosed between 2004 and 2017 in the National Cancer Database were studied. Survival differences were compared using Cox modeling to estimate hazard ratio (HR) or adjusted HR (AHR) and 95% confidence interval (CI). The contribution of demographic, socioeconomic and clinical factors to the Black vs White differences in survival was estimated after applying propensity score weighting in patients with squamous cell carcinoma (SCC) or adenocarcinoma (AC). Results: This study included 10,111 Black and 43,252 White patients with cervical cancer. Black patients had worse survival than White cervical cancer patients (HR = 1.40, 95% CI = 1.35-1.45). Survival disparities between Black and White patients varied significantly by histology (HR = 1.20, 95% CI = 1.15-1.24 for SCC; HR = 2.32, 95% CI = 2.12-2.54 for AC, interaction p < 0.0001). After balancing the selected demographic, socioeconomic and clinical factors, survival in Black vs. White patients was no longer different in those with SCC (AHR = 1.01, 95% CI 0.97-1.06) or AC (AHR = 1.09, 95% CI = 0.96-1.24). In SCC, the largest contributors to survival disparities were neighborhood income and insurance. In AC, age was the most significant contributor followed by neighborhood income, insurance, and stage. Diagnosis of AC (but not SCC) at ≥65 years old was more common in Black vs. White patients (26% vs. 13%, respectively). Conclusions: Histology matters in survival disparities and diagnosis at ≥65 years old between Black and White cervical cancer patients. These disparities were largely explained by modifiable factors. Competing Interests: Declaration of competing interest Chad A. Hamilton reported personal fees from GlaxoSmithKline outside the submitted work. Yovanni Casablanca cited personal fees from AstraZeneca outside the submitted work. John K. Chan reported personal fees from Agenus, AstraZeneca, Eisai, Genmab, GlaxoSmithKline, Immunogen, Mersana, Molecular Targeting Technologies, Myriad, Roche, and Seagen outside the submitted work. Thomas P. Conrads is a ThermoFisher Scientific, Inc. SAB member and receives research funding from AbbVie outside the submitted work. Charles A. Leath, III received funding from the NIH UG1 CA23330 and P50 CA098252, contracted research with Agenus and Seattle Genetics, and served on a scientific advisory board for Seattle Genetics, all outside of the submitted work. The other authors have no conflicts of interest to disclose. (Copyright © 2024 Elsevier Inc. All rights reserved.) |
| معلومات مُعتمدة: | P30 CA062203 United States CA NCI NIH HHS |
| فهرسة مساهمة: | Keywords: Adenocarcinoma; Cervical cancer; NCDB; Propensity score analysis; Racial disparities; Squamous cell carcinoma |
| تواريخ الأحداث: | Date Created: 20240210 Date Completed: 20240614 Latest Revision: 20240614 |
| رمز التحديث: | 20240615 |
| DOI: | 10.1016/j.ygyno.2024.02.005 |
| PMID: | 38340648 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1095-6859 |
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| DOI: | 10.1016/j.ygyno.2024.02.005 |