TY - JOUR
T1 - Socioeconomic and racial disparities in survival for patients with stage IV cancer
AU - Jogerst, Kristen
AU - Zhang, Chi
AU - Chang, Yu Hui
AU - Abujbarah, Sami
AU - Ali-Mucheru, Mariam
AU - Pockaj, Barbara
AU - Stucky, Chee Chee
AU - Cronin, Patricia
AU - Wasif, Nabil
N1 - Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/7
Y1 - 2023/7
N2 - Background: Disparities in cancer outcomes for minoritized people and groups experiencing disadvantages with Stage IV cancer is largely unknown. Methods: Patients with Stage IV pancreatic, colorectal, lung, breast, and prostate cancer were identified from 2004 to 2015 in the National Cancer Database. Cox proportional hazard models were used to quantify how demographics and treatments received were associated with overall survival. Results: 903,151 patients were included. Patients who were younger, non-Hispanic White, had private insurance, higher income, or received care at an academic center were more likely to receive surgery, chemotherapy, and/or radiation therapy (p < 0.001). Black patients, those with Medicare, Medicaid, no insurance, and lower income had lower survival rates across all five cancer types (p < 0.001). On multivariable analysis, receipt of surgery, radiation, and chemotherapy attenuated but did not eliminate this worse survival (p < 0.001). Conclusions: Survival for patients with Stage IV cancer differs by socioeconomic and self-reported racial classifications.
AB - Background: Disparities in cancer outcomes for minoritized people and groups experiencing disadvantages with Stage IV cancer is largely unknown. Methods: Patients with Stage IV pancreatic, colorectal, lung, breast, and prostate cancer were identified from 2004 to 2015 in the National Cancer Database. Cox proportional hazard models were used to quantify how demographics and treatments received were associated with overall survival. Results: 903,151 patients were included. Patients who were younger, non-Hispanic White, had private insurance, higher income, or received care at an academic center were more likely to receive surgery, chemotherapy, and/or radiation therapy (p < 0.001). Black patients, those with Medicare, Medicaid, no insurance, and lower income had lower survival rates across all five cancer types (p < 0.001). On multivariable analysis, receipt of surgery, radiation, and chemotherapy attenuated but did not eliminate this worse survival (p < 0.001). Conclusions: Survival for patients with Stage IV cancer differs by socioeconomic and self-reported racial classifications.
KW - Minoritized
KW - Outcomes
KW - Stage IV cancer
KW - Survival
KW - Treatment disparities
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U2 - 10.1016/j.amjsurg.2023.03.003
DO - 10.1016/j.amjsurg.2023.03.003
M3 - Article
C2 - 36922322
AN - SCOPUS:85150367440
SN - 0002-9610
VL - 226
SP - 20
EP - 27
JO - American journal of surgery
JF - American journal of surgery
IS - 1
ER -