Survival disparities in non-Hispanic Black and White cervical cancer patients vary by histology and are largely explained by modifiable factors

被引：0

作者：

Kucera, Calen W. ^{[1
,2
]}

Chappell, Nicole P. ^{[3
]}

Tian, Chunqiao ^{[1
,2
,4
]}

Richardson, Michael T. ^{[5
]}

Tarney, Christopher M. ^{[1
,2
]}

Hamilton, Chad A. ^{[6
,7
]}

Chan, John K. ^{[8
]}

Kapp, Daniel S. ^{[9
]}

Leath III, Charles A. ^{[9
]}

Casablanca, Yovanni ^{[10
]}

Rojas, Christine ^{[11
]}

Sitler, Collin A. ^{[1
,2
]}

Wenzel, Lari ^{[12
]}

Klopp, Ann ^{[13
]}

Jones, Nathaniel L. ^{[14
]}

Rocconi, Rodney P. ^{[15
,16
]}

Farley, John H. ^{[17
]}

O'Connor, Timothy D. ^{[18
,19
,20
,21
]}

Shriver, Craig D. ^{[2
]}

Bateman, Nicholas W. ^{[2
]}

Conrads, Thomas P. ^{[1
,2
,22
]}

Phippen, Neil T. ^{[1
,2
]}

Maxwell, G. Larry ^{[1
,2
,22
]}

Darcy, Kathleen M. ^{[1
,2
,4
,23
]}

机构：

[1] Uniformed Serv Univ Hlth Sci, Gynecol Canc Ctr Excellence, Walter Reed Natl Mil Med Ctr, Dept Gynecol Surg & Obstet, Bethesda, MD USA

[2] Uniformed Serv Univ Hlth Sci, Dept Surg, Walter Reed Natl Mil Med Ctr, Murtha Canc Ctr Res Program, Bethesda, MD USA

[3] George Washington Med Fac Associates, George Washington Canc Ctr, Washington, DC USA

[4] Henry M Jackson Fdn Advancement Mil Med, Bethesda, MD USA

[5] Univ Calif Los Angeles, Sch Med, Dept Obstet & Gynecol, Los Angeles, CA USA

[6] Womens Serv, Gynecol Oncol Sect, Ochsner Hlth, New Orleans, LA USA

[7] Ochsner Hlth, Ochsner Canc Inst, New Orleans, LA USA

[8] Sutter Hlth, Calif Pacific Med Ctr Sutter Hlth, Calif Pacific Med Ctr, San Francisco, CA USA

[9] Stanford Univ, Dept Radiat Oncol, Sch Med, Stanford, CA USA

[10] Atrium Hlth, Levine Canc Inst, Div Gynecol Oncol, Charlotte, NC USA

[11] Naval Med Ctr Portsmouth, Div Gynecol Oncol, Portsmouth, VA USA

[12] Univ Calif Irvine, Sch Med, Irvine, CA USA

[13] Univ Texas MD Anderson Canc Ctr, Dept Radiat Oncol, Houston, TX USA

[14] Univ S Alabama, Mitchell Canc Inst, Div Gynecol Oncol, Mobile, AL USA

[15] Univ Mississippi, Canc Ctr, Div Gynecol Oncol, Med Ctr, Jackson, MS USA

[16] Univ Mississippi, Res Inst, Med Ctr, Jackson, MS USA

[17] Dign Hlth St Josephs Hosp & Med Ctr, Canc Inst, Ctr Womens Hlth, Div Gynecol Oncol, Dign Hlth St, Phoenix, AZ USA

[18] Univ Maryland, Inst Genome Sci, Dept Med, Sch Med, Baltimore, MD USA

[19] Univ Maryland, Program Personalized & Genom Med, Sch Med, Baltimore, MD USA

[20] Univ Maryland, Program Hlth Equ & Populat Hlth, Sch Med, Baltimore, MD USA

[21] Univ Maryland, Marlene & Stewart Greenebaum Comprehens Canc Ctr, Baltimore, MD USA

[22] Womens Hlth Integrated Res Ctr, Inova Womens Serv Line, Inova Hlth Syst, Falls Church, VA USA

[23] Womens Hlth Integrated Res Ctr Inova Hlth Syst, Gynecol Canc Ctr Excellence, 3289 Woodburn Rd,Suite 370, Annandale, VA 22003 USA

来源：

GYNECOLOGIC ONCOLOGY | 2024年 / 184卷

关键词：

Cervical cancer; Racial disparities; Propensity score analysis; Adenocarcinoma; Squamous cell carcinoma; NCDB; UNITED-STATES; ETHNIC DISPARITIES; RACIAL DISPARITIES; WOMEN; ADENOCARCINOMA; DIAGNOSIS; MORTALITY; STAGE; TRENDS; RATES;

D O I：

10.1016/j.ygyno.2024.02.005

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

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. (c) 2024 Elsevier Inc. All rights reserved.

引用

页码：224 / 235

页数：12

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