Patterns of Care and Data Quality in a National Registry of Black and White Patients with Merkel Cell Carcinoma
Merkel Cell Carcinoma (MCC) is a rare cancer most commonly affecting White patients; less is known for Black patients. We aim to report presentation, treatment, and quality of registry data by race with a secondary endpoint of overall survival. We conducted a retrospective cohort analysis between 20...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/20/5059 |
| _version_ | 1797474505658990592 |
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| author | Abbas Rattani Jeremy Gaskins Grant McKenzie Virginia Kate Scharf Kristy Broman Maria Pisu Ashley Holder Neal Dunlap David Schwartz Mehran B. Yusuf |
| author_facet | Abbas Rattani Jeremy Gaskins Grant McKenzie Virginia Kate Scharf Kristy Broman Maria Pisu Ashley Holder Neal Dunlap David Schwartz Mehran B. Yusuf |
| author_sort | Abbas Rattani |
| collection | DOAJ |
| description | Merkel Cell Carcinoma (MCC) is a rare cancer most commonly affecting White patients; less is known for Black patients. We aim to report presentation, treatment, and quality of registry data by race with a secondary endpoint of overall survival. We conducted a retrospective cohort analysis between 2006–2017 via the National Cancer Database of Black and White MCC patients with and without known staging information. Multivariable logistic, proportional odds logistic, and baseline category logistic regression models were used for our primary endpoint. Multivariable Cox regression was used to interrogate overall survival. Multiple imputation was used to mitigate missing data bias. 34,503 patients with MCC were included (2566 Black patients). Black patients were younger (median age 52 vs. 72, <i>p</i> < 0.0001), had higher rates of immunosuppression (28% vs. 14%, <i>p</i> = 0.0062), and were more likely to be diagnosed at a higher stage (proportional OR = 1.41, 95% CI 1.25–1.59). No differences were noted by race across receipt of definitive resection (DR), though Black patients did have longer time from diagnosis to DR. Black patients were less likely to receive adjuvant radiation. Black patients were more likely to have missing cancer stage (OR = 1.69, CI 1.52–1.88). Black patients had decreased adjusted risk of mortality (HR 0.73, 0.65–0.81). Given the importance of registry analyses for rare cancers, efforts are needed to ensure complete data coding. Paramount to ensuring equitable access to optimal care for all is the recognition that MCC can occur in Black patients. |
| first_indexed | 2024-03-09T20:32:00Z |
| format | Article |
| id | doaj.art-60f0d37a72064d14b8ed02e37b8318d9 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T20:32:00Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-60f0d37a72064d14b8ed02e37b8318d92023-11-23T23:21:16ZengMDPI AGCancers2072-66942022-10-011420505910.3390/cancers14205059Patterns of Care and Data Quality in a National Registry of Black and White Patients with Merkel Cell CarcinomaAbbas Rattani0Jeremy Gaskins1Grant McKenzie2Virginia Kate Scharf3Kristy Broman4Maria Pisu5Ashley Holder6Neal Dunlap7David Schwartz8Mehran B. Yusuf9Department of Radiation Oncology, Tufts University Medical Center, Boston, MA 02111, USADepartment of Bioinformatics and Biostatistics, School of Public Health and Information Science, University of Louisville, Louisville, KY 40202, USADepartment of Radiation Oncology, Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY 40202, USASchool of Medicine, University of Louisville, Louisville, KY 40202, USADepartment of Surgery, Division of Surgical Oncology, University of Alabama at Birmingham, Birmingham, AL 35294, USADepartment of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USADepartment of Surgery, Division of Surgical Oncology, University of Alabama at Birmingham, Birmingham, AL 35294, USADepartment of Radiation Oncology, Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY 40202, USADepartment of Radiation Oncology, University of Tennessee Health Science Center, Memphis, TN 38163, USADepartment of Radiation Oncology, O’Neal Comprehensive Cancer Center, School of Medicine University of Alabama at Birmingham, Birmingham, AL 35294, USAMerkel Cell Carcinoma (MCC) is a rare cancer most commonly affecting White patients; less is known for Black patients. We aim to report presentation, treatment, and quality of registry data by race with a secondary endpoint of overall survival. We conducted a retrospective cohort analysis between 2006–2017 via the National Cancer Database of Black and White MCC patients with and without known staging information. Multivariable logistic, proportional odds logistic, and baseline category logistic regression models were used for our primary endpoint. Multivariable Cox regression was used to interrogate overall survival. Multiple imputation was used to mitigate missing data bias. 34,503 patients with MCC were included (2566 Black patients). Black patients were younger (median age 52 vs. 72, <i>p</i> < 0.0001), had higher rates of immunosuppression (28% vs. 14%, <i>p</i> = 0.0062), and were more likely to be diagnosed at a higher stage (proportional OR = 1.41, 95% CI 1.25–1.59). No differences were noted by race across receipt of definitive resection (DR), though Black patients did have longer time from diagnosis to DR. Black patients were less likely to receive adjuvant radiation. Black patients were more likely to have missing cancer stage (OR = 1.69, CI 1.52–1.88). Black patients had decreased adjusted risk of mortality (HR 0.73, 0.65–0.81). Given the importance of registry analyses for rare cancers, efforts are needed to ensure complete data coding. Paramount to ensuring equitable access to optimal care for all is the recognition that MCC can occur in Black patients.https://www.mdpi.com/2072-6694/14/20/5059Merkel Cell Carcinomaraceepidemiology |
| spellingShingle | Abbas Rattani Jeremy Gaskins Grant McKenzie Virginia Kate Scharf Kristy Broman Maria Pisu Ashley Holder Neal Dunlap David Schwartz Mehran B. Yusuf Patterns of Care and Data Quality in a National Registry of Black and White Patients with Merkel Cell Carcinoma Cancers Merkel Cell Carcinoma race epidemiology |
| title | Patterns of Care and Data Quality in a National Registry of Black and White Patients with Merkel Cell Carcinoma |
| title_full | Patterns of Care and Data Quality in a National Registry of Black and White Patients with Merkel Cell Carcinoma |
| title_fullStr | Patterns of Care and Data Quality in a National Registry of Black and White Patients with Merkel Cell Carcinoma |
| title_full_unstemmed | Patterns of Care and Data Quality in a National Registry of Black and White Patients with Merkel Cell Carcinoma |
| title_short | Patterns of Care and Data Quality in a National Registry of Black and White Patients with Merkel Cell Carcinoma |
| title_sort | patterns of care and data quality in a national registry of black and white patients with merkel cell carcinoma |
| topic | Merkel Cell Carcinoma race epidemiology |
| url | https://www.mdpi.com/2072-6694/14/20/5059 |
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