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African American Race and Low Income Neighborhoods Decrease Cause Specific Survival of Endometrial Cancer: A SEER Analysis


Abstract

Background: This study analyzed Surveillance, Epidemiology and End Results (SEER) data to assess if socio-economic factors (SEFs) impact on endometrial cancer survival. Materials and Methods: Endometrial cancer patients treated from 2004-2007 were included in this study. SEER cause specific survival (CSS) data were used as end points. The areas under the receiver operating characteristic (ROC) curve were computed for predictors. Time to event data were analyzed with Kaplan-Meier method. Univariate and multivariate analyses were used to identify independent risk factors. Results: This study included 64,710 patients. The mean follow up time (S.D.) was 28.2 (20.8) months. SEER staging (ROC area of 0.81) was the best pretreatment predictor of CSS. Histology, grade, race/ethnicity and county level family income were also significant pretreatment predictors. African American race and low income neighborhoods decreased the CSS by 20% and 3% respectively at 5 years. Conclusions: This study has found significant endometrial survival disparities due to SEFs. Future studies should focus on eliminating socio-economic barriers to good outcomes.

Keywords

References

  1. Berrington de Gonzalez A, Curtis RE, Kry SF, et al (2011) Proportion of second cancers attributable to radiotherapy treatment in adults: a cohort study in the US SEER cancer registries. Lancet Oncol, 12, 353-60. https://doi.org/10.1016/S1470-2045(11)70061-4
  2. Bhatia S (2011). Disparities in cancer outcomes: lessons learned from children with cancer. Pediatr Blood Cancer, 56, 994-1002. https://doi.org/10.1002/pbc.23078
  3. Cheung MC, Zhuge Y, Yang R, et al (2010). Incidence and outcomes of extremity soft-tissue sarcomas in children. J Surg Res, 163, 282-9. https://doi.org/10.1016/j.jss.2010.04.033
  4. Cheung, R. (2012). Poor treatment outcome of neuroblastoma and other peripheral nerve cell tumors may be related to under usage of radiotherapy and socio-economic disparity: a uS SEER data analysis. Asian Pac J Cancer Prev, 13, 4587-91. https://doi.org/10.7314/APJCP.2012.13.9.4587
  5. Cheung R, Altschuler MD, D'Amico AV, et al (2001a). ROC-optimization may improve risk stratification of prostate cancer patients. Urology, 57, 286-90. https://doi.org/10.1016/S0090-4295(00)00911-0
  6. Cheung R, Altschuler MD, D'A,ico AV, et al (2001b). Using the receiver operator characteristic curve to select pretreatment and pathologic predictors for early and late post-prostatectomy PSA failure. Urology, 58, 400-5. https://doi.org/10.1016/S0090-4295(01)01209-2
  7. Duong LM, Wilson RJ, Ajani UA, Singh SD, Eheman CR (2011). Trends in endometrial cancer incidence rates in the United States, 1999-2006. J Womens Hlth (Larchmt), 20, 1157-63. https://doi.org/10.1089/jwh.2010.2529
  8. Felix AS, Linkov F, Maxwell GL, Rain C, Taioli E (2011). Racial disparities in risk of second primary cancers in endometrial cancer patients: analysis of SEER Data. Int J Gynecol Cancer, 21, 309-15.
  9. Hanley JA, McNeil BJ (1982). The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology 143, 29-36. https://doi.org/10.1148/radiology.143.1.7063747
  10. Koskas M, Bendifallah S, Luton D, Darai E, Rouzier R (2011). Independent external validation of radiotherapy and its impact on the accuracy of a nomogram for predicting survival of women with endometrial cancer. Gynecol Oncol, 123, 214-20. https://doi.org/10.1016/j.ygyno.2011.08.006
  11. Ludwig J. Sanbonmatsu L, Gennetian L, et al (2011). Neighborhoods, obesity, and diabetes--a randomized social experiment. N Engl J Med, 365, 1509-19. https://doi.org/10.1056/NEJMsa1103216
  12. McDowell HP, Foot AB, Ellershaw C (2010). Outcomes in paediatric metastatic rhabdomyosarcoma: results of the international society of paediatric oncology (SIOP) study MMT-98. Eur J Cancer, 46, 1588-95. https://doi.org/10.1016/j.ejca.2010.02.051
  13. Ognjanovic S, Linabery AM, Charbonneau B, Ross JA (2009). Trends in childhood rhabdomyosarcoma incidence and survival in the United States, 1975-2005. Cancer, 115, 4218-26. https://doi.org/10.1002/cncr.24465
  14. Olson SH, Atoria CL, Cote ML, et al (2012). The impact of race and comorbidity on survival in endometrial cancer. Cancer Epidemiol Biomarkers Prev, 21, 753-60. https://doi.org/10.1158/1055-9965.EPI-11-0735
  15. Pappo AS, Krailo M, Chen Z, Rodriguez-Galindo C, Reaman G (2010). Infrequent tumor initiative of the children's Oncology Group: initial lessons learned and their impact on future plans. J Clin Oncol, 28, 5011-16. https://doi.org/10.1200/JCO.2010.31.2603
  16. Patel MK, Cote ML, Ali-Fehmi R, et al (2012). Trends in the utilization of adjuvant vaginal cuff brachytherapy and/ or external beam radiation treatmnt in stage I and II endometrial cancer: a surveillance, epidemiology, and endresults study. Int J Radiat Oncol Biol Phys, 83, 178-84. https://doi.org/10.1016/j.ijrobp.2011.05.052
  17. Perez EA, Kassira N, Cheung MC, et al (2011) . Rhabdomyosarcoma in children: a SEER population based study. J Surg Res, 170, 243-51. https://doi.org/10.1016/j.jss.2011.03.001
  18. Sultan I, Qaddoumi I Yaser S, Rodriguez-Galindo C, Ferrari A (2009). Comparing adult and pediatric rhabkomyosarcoma in the surveillance, epidemiology and end results program, 1973 to 2005: an analysis of 2,600 patients. J Clin Oncol, 27, 3391-7. https://doi.org/10.1200/JCO.2008.19.7483
  19. Wright JD, Barrena Medel NI, Sehouli J, et al (2012). Contemporary management of endometrial cancer. Lancet, 379, 1352-60. https://doi.org/10.1016/S0140-6736(12)60442-5

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