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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
Author(s) -
Tsao Miriam W.,
Delozier Olivia M.,
Stiles Zachary E.,
Magnotti Louis J.,
Behrman Stephen W.,
Deneve Jeremiah L.,
Glazer Evan S.,
Shibata David,
Yakoub Danny,
Dickson Paxton V.
Publication year - 2020
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25827
Subject(s) - medicine , socioeconomic status , demography , cancer , population , cohort , retrospective cohort study , multivariate analysis , ethnic group , helicobacter pylori , gerontology , environmental health , sociology , anthropology
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.