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美国西班牙裔胃癌患者确诊时的分期差异

Disparities in Stage at Diagnosis among Hispanic Patients with Gastric Cancer in the United States.

作者信息

Jeri-Yabar Antoine, Vittini-Hernandez Liliana, Aller-Rojas Renzo, Arias-Reyes Francisco, Dharmapuri Sirish

机构信息

Department of Internal Medicine, Icahn School of Medicine at Mount Sinai Morningside/West, New York, NY 10023, USA.

Department of Internal Medicine, University of Texas Rio Grande Valley, McAllen, TX 78503, USA.

出版信息

Cancers (Basel). 2024 Sep 27;16(19):3308. doi: 10.3390/cancers16193308.

Abstract

INTRODUCTION

Racial disparities in gastric cancer outcomes, including stage at diagnosis and overall survival, continue to affect Hispanic and non-Hispanic populations. This study aims to evaluate these disparities across different racial groups.

PATIENTS AND METHODS

We conducted a retrospective cohort study using SEER data from 2018 to 2021, including 18,984 patients diagnosed with gastric cancer. Patients were selected based on ICD-O-3 codes for "stomach" with malignant behavior. Using ordered logistic regression, the association between race and stage at diagnosis was analyzed, while Cox proportional hazards models were used to assess OS and CSS.

RESULTS

Hispanic patients were significantly more likely to be diagnosed at a later stage compared to non-Hispanic patients (OR: 1.19; 95% CI: 1.10-1.28). Both Hispanic and Black patients had worse OS compared to Non-Hispanic Whites (HR 1.10 CI 1.03-1.17, = 0.003 and HR 1.13 CI 1.04-1.22, = 0.002, respectively) as well as CSS.

CONCLUSIONS

Hispanic patients are more likely to be diagnosed with advanced-stage gastric cancer and have poorer survival outcomes compared to non-Hispanic Whites. These disparities may be linked to differences in healthcare access, insurance, language barriers, and preventive care utilization.

摘要

引言

胃癌治疗结果方面的种族差异,包括诊断时的分期和总生存期,持续影响着西班牙裔和非西班牙裔人群。本研究旨在评估不同种族群体之间的这些差异。

患者与方法

我们使用2018年至2021年的监测、流行病学和最终结果(SEER)数据进行了一项回顾性队列研究,纳入了18984例被诊断为胃癌的患者。根据国际疾病分类肿瘤学第三版(ICD - O - 3)中“胃”的恶性行为编码选择患者。使用有序逻辑回归分析种族与诊断分期之间的关联,同时使用Cox比例风险模型评估总生存期(OS)和癌症特异性生存期(CSS)。

结果

与非西班牙裔患者相比,西班牙裔患者在更晚阶段被诊断的可能性显著更高(比值比:1.19;95%置信区间:1.10 - 1.28)。与非西班牙裔白人相比,西班牙裔和黑人患者的总生存期以及癌症特异性生存期均较差(风险比分别为1.10,置信区间1.03 - 1.17,P = 0.003;以及1.13,置信区间1.04 - 1.22,P = 0.002)。

结论

与非西班牙裔白人相比,西班牙裔患者更有可能被诊断为晚期胃癌,且生存结果更差。这些差异可能与医疗保健可及性、保险、语言障碍和预防性医疗服务利用方面的差异有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa6c/11475899/c9b0b9b12083/cancers-16-03308-g001.jpg

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