Faculty Collaboration Database

The impact of race and socioeconomic status on the presentation, management and outcomes for gastric cancer patients: Analysis from a metropolitan area in the southeast United States. J Surg Oncol 2020 Mar;121(3):494-502

Date

01/07/2020

Pubmed ID

31902137

DOI

10.1002/jso.25827

Scopus ID

2-s2.0-85078614756 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

BACKGROUND: Socioeconomic disparities in gastric cancer have been associated with differences in care and inferior outcomes. We evaluated the presentation, treatment, and survival for patients with gastric cancer (GC) in a metropolitan setting with a large African American population.

METHODS: Retrospective cohort analysis of patients with GC (2003-2018) across a multi-hospital system was performed. Associations between socioeconomic and clinicopathologic data with the presentation, treatment, and survival were examined.

RESULTS: Of 359 patients, 255 (71%) were African American and 104 (29%) Caucasian. African Americans were more likely to present at a younger age (64.0 vs 72.5, P < .001), have state-sponsored or no insurance (19.7% vs 6.9%, P = .02), reside within the lowest 2 quintiles for median income (67.4% vs 32.7%, P < .001), and have higher rates of Helicobacter pylori (14.9% vs 4.8%, P = .02). Receipt of multi-modality therapy was not impacted by race or insurance status. On multivariable analysis, only AJCC T class (HR 1.68) and node positivity (HR 2.43) remained significant predictors of disease-specific survival.

CONCLUSION: Despite socioeconomic disparities, African Americans, and Caucasians with GC had similar treatment and outcomes. African Americans presented at a younger age with higher rates of H. pylori positivity, warranting further investigation into differences in risk factors and tumor biology.

Author List

Tsao MW, Delozier OM, Stiles ZE, Magnotti LJ, Behrman SW, Deneve JL, Glazer ES, Shibata D, Yakoub D, Dickson PV

MESH terms used to index this publication - Major topics in bold

Aged
Combined Modality Therapy
Disease Management
Female
Follow-Up Studies
Helicobacter Infections
Helicobacter pylori
Humans
Income
Male
Middle Aged
Prognosis
Retrospective Studies
Risk Factors
Social Class
Stomach Neoplasms
Survival Rate
United States