Even after adjustments, the underlying trends in disparities persisted, underscoring the significance of survival disparities among second primary cancer survivors.
Data published in JAMA Network Open revealed striking differences in cancer-related and cardiovascular-related deaths across different racial and ethnic groups.1
In a recent cohort study involving individuals diagnosed with second primary cancers (SPCs), investigators shed light on concerning racial and ethnic disparities in survival rates within the United States. The study sought to fill a significant gap in knowledge regarding such disparities, by utilizing extensive data from 18 Surveillance, Epidemiology, and End Results (SEER) registries covering January 2000 to December 2013, with follow-up extending until December 2018.
Hyuna Sung, PhD, Surveillance & Health Equity Science, American Cancer Society, and the team of investigators conducted the population-based retrospective cohort study, which evaluated the survival outcomes of more than 230,000 individuals aged 20 years or older who had been diagnosed with common SPCs.
The study's objective was to assess the disparities in survival between various racial and ethnic groups. The data, analyzed between January and April 2023, exposed critical discrepancies in survival rates among different populations.
Results showed 58.4% of the study population was male, 4.5% were Asian or Pacific Islander, 9.6% were Black, 6.4% were Hispanic, and 79.5% were White. Investigators reported that a total of 109,757 cancer-related deaths (47.6%) and 18,283 CVD-related deaths (7.9%) occurred during the median follow-up of 54 months (IQR, 12-93 months).
Among the cohort of SPC survivors, the data demonstrated that disparities in survival outcomes were starkly evident across racial and ethnic lines.
Compared with the White population, the Black (HR, 1.21; 95% CI, 1.18-1.23) and Hispanic populations (HR, 1.10; 95% CI, 1.07-1.13) faced a significantly higher risk of cancer-related deaths. Additionally, the Black population exhibited a higher risk of cardiovascular-related deaths (HR, 1.41; 95% CI, 1.34-1.49), while the Asian or Pacific Islander (HR, 0.75; 95% CI, 0.69-0.81) and Hispanic populations displayed a lower risk (HR, 0.90; 95% CI, 0.84-0.96).
When stratified by specific SPC types, the findings remained consistent. Investigators noted the Black population showed higher risks of cancer-related death for 10 of 13 SPC types, with uterine cancer standing out as a particularly prominent example (HR, 1.87; 95% CI, 1.63-2.15). The Hispanic population exhibited a higher risk of cancer-related death for 7 specific SPCs, including melanoma (HR, 1.46; 95% CI, 1.21-1.76).
The team further investigated the impact of potentially modifiable factors on survival disparities. Adjustments for county attributes, SPC characteristics, and treatment reduced the HR for both cancer-related and cardiovascular-related deaths. However, the underlying trends in disparities persisted, underscoring the significance of these findings in addressing and rectifying the survival disparities among SPC survivors.
“In this diverse, contemporary, population-based cohort study of 230,370 persons with SPCs, the Black and Hispanic populations compared with the White population had a higher risk of cancer-related death, with the greatest disparities commonly observed for persons with SPCs of the breast and corpus uteri and melanoma,” investigators wrote. “The Black population also experienced the greatest risk of death from CVD of all populations overall and across most SPCs.”
References
1. Sung H, Nisotel L, Sedeta E, Islami F, Jemal A. Racial and ethnic disparities in survival among people with second primary cancer in the US. JAMA Netw Open. 2023;6(8):e2327429. doi:10.1001/jamanetworkopen.2023.27429
Integrating RECIST and Clinician Approaches Boosts NSCLC Research
May 8th 2024Outcomes among patients with stage IV non–small cell lung cancer as evaluated within clinical trials via Response Evaluation Criteria in Solid Tumors (RECIST) and clinician response criteria in observational studies were compared for their concordance and reliability.
Read More
CMS Medicare Final Rule: Advancing Benefits, Competition, and Consumer Protection
May 7th 2024On this episode of Managed Care Cast, we're talking with Karen Iapoce, senior director of government products and programs at ZeOmega, about the recent CMS final rule on Medicare Part D and Medicare Advantage.
Listen
The Joint Commission is launching the Rural Health Clinic Accreditation Program to standardize staff training and patient care practices at rural health clinics nationwide; the American Cancer Society recently launched the largest-ever study of cancer risk and outcomes in Black women; the HHS COVID-19 vaccination campaign saved $732 billion by preventing illness and related costs.
Read More
Tackling Health Inequality: The Power of Education and Experience
April 30th 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our final episode of this limited series and our conversation with Janine Jelks-Seale, MSPPM, director of health equity at UPMC Health Plan.
Listen
AA Unlikely to Cause Anxiety, Depression but May Be Affected by Mental Illness
May 7th 2024A Mendelian randomization study using genetic analysis found that alopecia areata (AA) increases the risk of anxiety and depression, but not the other way around, providing unique evidence for a causal link while adding to existing evidence.
Read More