Racial disparities in receipt of standard chemoradiation in anal squamous cell carcinoma, an analysis of the National Cancer Database
Abstract Background Standard treatment for locally advanced anal squamous cell carcinoma (SCC) consists of concurrent chemoradiation. We evaluated whether racial differences exist in the receipt of standard treatment and its association with survival. Methods From the National Cancer Database, we id...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.3625 |
| _version_ | 1818657013338472448 |
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| author | Shelly X. Bian Dennis H. Chen Eugene Lin |
| author_facet | Shelly X. Bian Dennis H. Chen Eugene Lin |
| author_sort | Shelly X. Bian |
| collection | DOAJ |
| description | Abstract Background Standard treatment for locally advanced anal squamous cell carcinoma (SCC) consists of concurrent chemoradiation. We evaluated whether racial differences exist in the receipt of standard treatment and its association with survival. Methods From the National Cancer Database, we identified patients diagnosed with anal SCC (Stages 2–3) between 2004 and 2015. Using logistic regression, we evaluated racial differences in the probability of receiving standard chemoradiation. We used Cox proportional hazards models to evaluate associations between race, receipt of standard therapy and survival. Results Our analysis included 19,835 patients. Patients receiving standard chemoradiation had better survival than patients receiving nonstandard therapy (hazard ratio [HR] 0.64; 95% confidence interval [CI] 0.61–0.68; p < 0.001). Compared to White patients, Black patients were less likely to receive standard therapy (odds ratio [OR] 0.85; 95% CI 0.76–0.96; p < 0.008). We observed no statistical difference in mortality between Black and White patients overall (HR 1.05, 95% CI 0.97–1.15; p = 0.24). However, for the subgroup of patients receiving nonstandard therapy, Black patients had an increased mortality risk compared to White patients (HR 1.17, CI 1.01–1.35; p = 0.034). We observed no survival differences in the subgroup of patients receiving standard treatment (HR 1.00, CI 0.90–1.11, p = 0.99). Conclusion Standard treatment in anal SCC is associated with better survival, but Black patients are less likely to receive standard treatment than White patients. Although Black patients had higher mortality than White patients in the subgroup of patients receiving nonstandard therapy, this difference was ameliorated in the subset receiving standard therapy. |
| first_indexed | 2024-12-17T03:34:43Z |
| format | Article |
| id | doaj.art-4171587e40934a438efe27d74e537252 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-12-17T03:34:43Z |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-4171587e40934a438efe27d74e5372522022-12-21T22:05:09ZengWileyCancer Medicine2045-76342021-01-0110257558510.1002/cam4.3625Racial disparities in receipt of standard chemoradiation in anal squamous cell carcinoma, an analysis of the National Cancer DatabaseShelly X. Bian0Dennis H. Chen1Eugene Lin2Department of Radiation Oncology Keck School of Medicine University of Southern California Los Angeles CA USADepartment of Radiation Oncology Keck School of Medicine University of Southern California Los Angeles CA USADepartment of Medicine Division of Nephrology University of Southern California Los Angeles CA USAAbstract Background Standard treatment for locally advanced anal squamous cell carcinoma (SCC) consists of concurrent chemoradiation. We evaluated whether racial differences exist in the receipt of standard treatment and its association with survival. Methods From the National Cancer Database, we identified patients diagnosed with anal SCC (Stages 2–3) between 2004 and 2015. Using logistic regression, we evaluated racial differences in the probability of receiving standard chemoradiation. We used Cox proportional hazards models to evaluate associations between race, receipt of standard therapy and survival. Results Our analysis included 19,835 patients. Patients receiving standard chemoradiation had better survival than patients receiving nonstandard therapy (hazard ratio [HR] 0.64; 95% confidence interval [CI] 0.61–0.68; p < 0.001). Compared to White patients, Black patients were less likely to receive standard therapy (odds ratio [OR] 0.85; 95% CI 0.76–0.96; p < 0.008). We observed no statistical difference in mortality between Black and White patients overall (HR 1.05, 95% CI 0.97–1.15; p = 0.24). However, for the subgroup of patients receiving nonstandard therapy, Black patients had an increased mortality risk compared to White patients (HR 1.17, CI 1.01–1.35; p = 0.034). We observed no survival differences in the subgroup of patients receiving standard treatment (HR 1.00, CI 0.90–1.11, p = 0.99). Conclusion Standard treatment in anal SCC is associated with better survival, but Black patients are less likely to receive standard treatment than White patients. Although Black patients had higher mortality than White patients in the subgroup of patients receiving nonstandard therapy, this difference was ameliorated in the subset receiving standard therapy.https://doi.org/10.1002/cam4.3625analcancerchemoradiationdisparityracesquamous |
| spellingShingle | Shelly X. Bian Dennis H. Chen Eugene Lin Racial disparities in receipt of standard chemoradiation in anal squamous cell carcinoma, an analysis of the National Cancer Database Cancer Medicine anal cancer chemoradiation disparity race squamous |
| title | Racial disparities in receipt of standard chemoradiation in anal squamous cell carcinoma, an analysis of the National Cancer Database |
| title_full | Racial disparities in receipt of standard chemoradiation in anal squamous cell carcinoma, an analysis of the National Cancer Database |
| title_fullStr | Racial disparities in receipt of standard chemoradiation in anal squamous cell carcinoma, an analysis of the National Cancer Database |
| title_full_unstemmed | Racial disparities in receipt of standard chemoradiation in anal squamous cell carcinoma, an analysis of the National Cancer Database |
| title_short | Racial disparities in receipt of standard chemoradiation in anal squamous cell carcinoma, an analysis of the National Cancer Database |
| title_sort | racial disparities in receipt of standard chemoradiation in anal squamous cell carcinoma an analysis of the national cancer database |
| topic | anal cancer chemoradiation disparity race squamous |
| url | https://doi.org/10.1002/cam4.3625 |
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