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Impact of prognostic factor distributions on mortality disparities for socioeconomically disadvantaged cancer patients. | LitMetric

Impact of prognostic factor distributions on mortality disparities for socioeconomically disadvantaged cancer patients.

Ann Epidemiol

Center for Epidemiology and Healthcare Delivery Research, JPS Health Network, Fort Worth, TX; Department of Medical Education, TCU & UNTHSC School of Medicine, Fort Worth, Texas. Electronic address:

Published: January 2022

AI Article Synopsis

  • The study aimed to explore if variations in prognostic factors could explain the differences in mortality rates between urban safety-net cancer patients and those tracked by the SEER program.
  • Researchers analyzed data from a safety-net center in Texas and SEER, focusing on adult patients diagnosed with breast, colorectal, or lung cancer between 2008 and 2016, assessing all-cause mortality at 3 and 5 years.
  • Findings indicated that while sociodemographic and tumor factors significantly reduced the initial mortality difference between the two groups, they did not account for disparities in late-stage mortality, suggesting other factors may be at play.

Article Abstract

Purpose: We aimed to assess whether differences in the distributions of prognostic factors explain reported mortality disparities between urban safety-net and Surveillance, Epidemiology, and End Results (SEER) cancer populations.

Methods: We used data from SEER and a safety-net cancer center in Texas. Eligible patients were adults aged ≤64 years and diagnosed with first primary female breast, colorectal, or lung cancer between 2008 and 2016. We estimated crude and adjusted risk differences (RD) in 3- and 5-year all-cause mortality (1- and 3-year for lung cancer), where adjustment was based on entropy balancing weights that standardized the distribution of sociodemographic and tumor characteristics between the two populations.

Results: Our study populations comprised 1914 safety-net patients and 389,709 SEER patients. For breast cancer, the crude 3- and 5-year mortality RDs between safety-net and SEER populations were 7.7% (95% confidence limits [CL]: 4.3%, 11%) and 11% (95% CL: 6.7%, 16%). Adjustment for measured prognostic factors reduced the mortality RDs (3-year adjusted RD = 0.049%, 95% CL: -2.6%, 2.6%; 5-year adjusted RD = 5.6%, 95% CL: -0.83%, 12%). We observed similar patterns for colorectal and lung cancer albeit less magnitude.

Conclusions: Sociodemographic and tumor characteristics may largely explain early mortality disparities between safety-net and SEER populations but not late mortality disparities.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.annepidem.2021.09.014DOI Listing

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