ASPO Abstracts
Racial/Ethnic Disparities in Esophageal and Gastric Cancer Mortality: Surveillance Epidemiology and End Results, 2000-2011
Category: Cancer Health Disparities
Conference Year: 2022
Abstract Body:
Purpose of the study: To better understand racial/ethnic disparities in esophageal cancer (EC) and gastric cancer (GC) mortality.Methods: We utilized data from the Surveillance Epidemiology and End Results (SEER)-18 registries which covers ~27% of the U.S population. SEER*stat case listing sessions identified first primary EC (n=32,406) and GC (n=60,901) cases diagnosed from 2000-2011. Cases were followed up until death or censoring through December 31st, 2016. Cox proportional models estimated hazard ratios for associations between race/ethnicity groups (non-Hispanic (NH)-White, NH-Black, Hispanic, American Indian/Alaska native and Asians) and subgroups (Indian/Pakistani, Chinese, Filipino, Hawaiian, Japanese, Korean, Vietnamese and other Asians/Pacific Islanders [PI]), and mortality risk. Associations were adjusted for age at diagnosis, year of cancer diagnosis, marital status, geographic region, census tract-level socioeconomic status, rurality index, cancer stage, histology, anatomical site (for GC), cancer directed surgery, and insurance status. A p-value of <0.05 was considered statistically significant. Results: After medians of 10 (EC) and 11 (GC) months of follow-up, 29,074 and 50,143 deaths from all-causes were reported among individuals with EC and GC, respectively. Compared to NH-Whites, the adjusted mortality risk from EC was significantly reduced in Hispanics (5%) and Asians (Chinese [19%] and Indian/Pakistani [35%]). All-cause mortality risk from GC was also significantly reduced in NH-Blacks (4%) and Hispanics (11%), and Asians (Japanese [9%], other Asians/PI [13%], Filipino [19%], Vietnamese [19%], Chinese [20%], Korean [26%] and Indian/Pakistani [36%]). The associations were not significant for the other racial/ethnic groups. Disease specific mortality risk were similar to those observed for all-causes. Conclusions: Persons with Asian ancestry demonstrated better survival outcomes after EC and GC diagnosis. Racial/ethnic disparities in survival were more apparent in GC and were more pronounced in Indian/Pakistani persons compared to those of other Asian ancestry. These results highlight the need for more research in racial disparities towards achieving health equity in cancer control.
Keywords: Racial/ethnic disparities, mortality risk, gastrointestinal cancers