Differences in Stage of Cancer at Diagnosis, Treatment, and Survival by Race and Ethnicity among Leading Cancer Types

Abstract

Importance: Information about stage of cancer at diagnosis, use of therapy, and survival among patients from different racial/ethnic groups with 1 of the most common cancers is lacking. Objective: To assess stage of cancer at diagnosis, use of therapy, overall survival (OS), and cancer-specific survival (CSS) in patients with cancer from different racial/ethnic groups. Design, Setting, and Participants: This cohort study included 950377 Asian, black, white, and Hispanic patients who were diagnosed with prostate, ovarian, breast, stomach, pancreatic, lung, liver, esophageal, or colorectal cancers from January 2004 to December 2010. Data were collected using the Surveillance, Epidemiology, and End Results (SEER) database, and patients were observed for more than 5 years. Data analysis was conducted in July 2018. Main Outcomes and Measures: Multivariable logistic and Cox regression were used to evaluate the differences in stage of cancer at diagnosis, treatment, and survival among patients from different racial/ethnic groups. Results: A total of 950377 patients (499070 [52.5%] men) were included in the study, with 681251 white patients (71.7%; mean [SD] age, 65 [12] years), 116015 black patients (12.2%; mean [SD] age, 62 [12] years), 65718 Asian patients (6.9%; mean [SD] age, 63 [13] years), and 87393 Hispanic patients (9.2%; mean [SD] age, 61 [13] years). Compared with Asian patients, black patients were more likely to have metastatic disease at diagnosis (odds ratio [OR], 1.144; 95% CI, 1.109-1.180; P