TY - JOUR
T1 - Racial Differences in the Incidence and Survival of Patients with Neuroendocrine Tumors
AU - Shen, Chan
AU - Gu, Dian
AU - Zhou, Shouhao
AU - Xu, Ying
AU - Sarshekeh, Amir Mehrvarz
AU - Halperin, Daniel
AU - Shih, Ya Chen T.
AU - Yao, James C.
AU - Dasari, Arvind
N1 - Funding Information:
The authors acknowledge the efforts of the Applied Research Program, National Cancer Institute; the Office of Research, Development and Information, Centers for Medicare & Medicaid Services; Information Management Services, Inc; and the SEER Program tumor registries in the creation of the SEER-Medicare database.
Funding Information:
From the *Division of Outcomes Research and Quality, Department of Surgery, and †Department of Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, PA; and Departments of ‡Health Services Research and §Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX. Received for publication May 21, 2019; accepted September 20, 2019. Address correspondence to: Chan Shen, PhD, Department of Surgery, College of Medicine, The Pennsylvania State University, 500 University Dr, H151, Hershey, PA 17033 (e‐mail: chanshen@psu.edu). This work was supported in part by Ipsen Pharma. The funder sponsored the purchase of SEER-Medicare data and provided funding for analytical support. All authors had unrestricted access to the final study data on request; were responsible for data interpretation, manuscript preparation, and the decision to submit for publication; and attest to the completeness and accuracy of the data and statistical analysis. No grant number is applicable. The authors declare no conflict of interest. This study used the linked SEER-Medicare database. The interpretation and reporting of these data are the sole responsibility of the authors. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved. DOI: 10.1097/MPA.0000000000001431
Publisher Copyright:
© 2019 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Objectives The incidence of neuroendocrine tumors (NETs) has been steadily increasing. Racial differences in the incidence and survival are mostly unknown. This study examines the racial differences and the underlying causes. Methods We conducted a retrospective, population-based study using datasets from Surveillance, Epidemiology, and End Results (SEER) cancer registry and SEER data linked with Medicare claims (SEER-Medicare). We examined the incidence rates and the effects of patient demographics, clinical characteristics, and socioeconomic factors on survival. Results Of the 15,786 and 1731 cases from SEER and SEER-Medicare, 1991 and 163 were blacks, respectively. We found that blacks had higher NET incidence for all stages, with the largest difference noted in the local stage (4.3 vs 2.6 per 100,000 in whites). We found worse survival for distant-stage black patients, although they more often had clinical factors typically associated with better prognosis in NETs. However, they were also found to have significant unfavorable differences in socioeconomic and sociodemographic factors. Conclusions Blacks have higher incidence of NETs and worse survival compared with other races, especially whites. The influences of neighborhood socioeconomic, sociodemographic, and marital status suggest that social determinants, support mechanisms, and access to health care may be contributing factors.
AB - Objectives The incidence of neuroendocrine tumors (NETs) has been steadily increasing. Racial differences in the incidence and survival are mostly unknown. This study examines the racial differences and the underlying causes. Methods We conducted a retrospective, population-based study using datasets from Surveillance, Epidemiology, and End Results (SEER) cancer registry and SEER data linked with Medicare claims (SEER-Medicare). We examined the incidence rates and the effects of patient demographics, clinical characteristics, and socioeconomic factors on survival. Results Of the 15,786 and 1731 cases from SEER and SEER-Medicare, 1991 and 163 were blacks, respectively. We found that blacks had higher NET incidence for all stages, with the largest difference noted in the local stage (4.3 vs 2.6 per 100,000 in whites). We found worse survival for distant-stage black patients, although they more often had clinical factors typically associated with better prognosis in NETs. However, they were also found to have significant unfavorable differences in socioeconomic and sociodemographic factors. Conclusions Blacks have higher incidence of NETs and worse survival compared with other races, especially whites. The influences of neighborhood socioeconomic, sociodemographic, and marital status suggest that social determinants, support mechanisms, and access to health care may be contributing factors.
UR - http://www.scopus.com/inward/record.url?scp=85074545024&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85074545024&partnerID=8YFLogxK
U2 - 10.1097/MPA.0000000000001431
DO - 10.1097/MPA.0000000000001431
M3 - Article
C2 - 31688604
AN - SCOPUS:85074545024
VL - 48
SP - 1373
EP - 1379
JO - Pancreas
JF - Pancreas
SN - 0885-3177
IS - 10
ER -
