Racial/Ethnic Disparities in Mortality Related to Access to Care for Major Cancers in the United States
Abstract
:Simple Summary
Abstract
1. Introduction
2. Methods
Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Cancer Site | Unadjusted 5-Year Survival Rates (%) | Adjusted 5-Year Survival Rates (%) * | ||||||
---|---|---|---|---|---|---|---|---|
NH-White | NH-Black | Hispanic | Asian | NH-White | NH-Black | Hispanic | Asian | |
Breast | 86.9 | 80.8 | 89.0 | 92.6 | 91.4 | 87.4 | 92.0 | 93.7 |
Ovary | 46.7 | 40.4 | 56.3 | 62.4 | 49.7 | 44.4 | 56.1 | 56.8 |
Prostate | 88.8 | 85.8 | 89.1 | 90.6 | 92.4 | 89.3 | 93.1 | 94.6 |
Colon and Rectum | 58.1 | 55.1 | 63.4 | 66.3 | 61.3 | 56.9 | 64.5 | 67.0 |
Pancreas | 9.6 | 10.0 | 14.1 | 14.0 | 3.7 | 4.8 | 8.0 | 7.0 |
Liver | 20.9 | 18.0 | 23.6 | 31.1 | 13.4 | 13.7 | 18.7 | 21.7 |
Lung | 19.7 | 17.9 | 23.0 | 26.0 | 11.5 | 12.5 | 19.5 | 22.2 |
Race/Ethnicity | HR (95% CI) * | ||||||
---|---|---|---|---|---|---|---|
Breast Cancer | Ovarian Cancer | Prostate Cancer | Colorectal Cancer | Pancreatic Cancer | Liver Cancer | Lung Cancer | |
NH-white | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
NH-black | 1.27 (1.26 to 1.29) | 1.20 (1.17 to 1.23) | 1.31 (1.30 to 1.33) | 1.11 (1.10 to 1.12) | 1.03 (1.02 to 1.05) | 1.00 (0.98 to 1.02) | 0.98 (0.97 to 0.98) |
Hispanic | 0.84 (0.83 to 0.86) | 0.84 (0.81 to 0.87) | 0.84 (0.82 to 0.86) | 0.87 (0.85 to 0.88) | 0.86 (0.84 to 0.88) | 0.82 (0.81 to 0.84) | 0.81 (0.80 to 0.82) |
Asian | 0.69 (0.67 to 0.71) | 0.80 (0.76 to 0.85) | 0.70 (0.67 to 0.73) | 0.79 (0.78 to 0.81) | 0.87 (0.85 to 0.90) | 0.78 (0.76 to 0.80) | 0.72 (0.71 to 0.73) |
HR (95% CI) | |||||||
---|---|---|---|---|---|---|---|
Breast Cancer | Ovarian Cancer | Prostate Cancer | Colorectal Cancer | Pancreatic Cancer | Liver Cancer | Lung Cancer | |
Neighborhood-level SES | |||||||
Low | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
Intermediate | 0.95 (0.94 to 0.96) | 0.93 (0.91 to 0.95) | 0.86 (0.85 to 0.88) | 0.95 (0.94 to 0.96) | 0.96 (0.94 to 0.97) | 0.98 (0.96 to 0.99) | 0.97 (0.96 to 0.97) |
High | 0.82 (0.81 to 0.83) | 0.84 (0.82 to 0.86) | 0.71 (0.70 to 0.72) | 0.86 (0.85 to 0.87) | 0.89 (0.88 to 0.90) | 0.91 (0.89 to 0.93) | 0.91 (0.90 to 0.92) |
Insurance | |||||||
Private | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
Not insured | 1.63 (1.59 to 1.67) | 1.21 (1.17 to 1.27) | 1.68 (1.62 to 1.74) | 1.44 (1.42 to 1.47) | 1.15 (1.12 to 1.18) | 1.24 (1.20 to 1.28) | 1.24 (1.23 to 1.26) |
Medicaid | 1.77 (1.74 to 1.79) | 1.32 (1.27 to 1.37) | 1.83 (1.78 to 1.89) | 1.50 (1.48 to 1.53) | 1.20 (1.18 to 1.23) | 1.19 (1.16 to 1.21) | 1.22 (1.21 to 1.23) |
Medicare | 1.23 (1.22 to 1.25) | 1.06 (1.04 to 1.08) | 1.18 (1.16 to 1.19) | 1.14 (1.13 to 1.15) | 1.07 (1.05 to 1.08) | 1.12 (1.10 to 1.14) | 1.10 (1.10 to 1.11) |
Other government | 1.17 (1.11 to 1.22) | 1.14 (1.05 to 1.25) | 1.38 (1.33 to 1.44) | 1.11 (1.07 to 1.15) | 1.06 (1.01 to 1.10) | 1.09 (1.03 to 1.15) | 1.05 (1.03 to 1.07) |
Unknown | 1.05 (1.02 to 1.08) | 0.95 (0.90 to 1.01) | 1.00 (0.97 to 1.04) | 1.10 (1.07 to 1.13) | 0.97 (0.94 to 1.00) | 1.09 (1.04 to 1.14) | 1.07 (1.05 to 1.08) |
Urban/rural Residence | |||||||
Metro | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
Urban | 1.03 (1.01 to 1.04) | 0.99 (0.96 to 1.01) | 1.01 (0.99 to 1.03) | 1.02 (1.01 to 1.03) | 1.03 (1.02 to 1.05) | 1.10 (1.07 to 1.12) | 1.01 (1.01 to 1.02) |
Rural | 1.02 (0.99 to 1.05) | 1.02 (0.96 to 1.08) | 0.97 (0.94 to 1.01) | 0.99 (0.96 to 1.01) | 1.02 (0.99 to 1.06) | 1.07 (1.01 to 1.14) | 1.01 (1.00 to 1.03) |
Unknown | 1.32 (1.29 to 1.35) | 1.26 (1.21 to 1.31) | 1.32 (1.28 to 1.36) | 1.27 (1.24 to 1.29) | 1.12 (1.09 to 1.14) | 1.20 (1.16 to 1.24) | 1.13 (1.12 to 1.15) |
Facility type | |||||||
Community | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
Comprehensive Community | 0.95 (0.94 to 0.96) | 1.00 (0.97 to 1.03) | 0.90 (0.89 to 0.92) | 0.98 (0.97 to 0.99) | 0.96 (0.94 to 0.97) | 0.95 (0.92 to 0.98) | 0.97 (0.96 to 0.98) |
Academic/Research | 0.85 (0.83 to 0.86) | 0.95 (0.92 to 0.98) | 0.76 (0.75 to 0.77) | 0.90 (0.89 to 0.91) | 0.81 (0.80 to 0.83) | 0.77 (0.74 to 0.79) | 0.89 (0.89 to 0.90) |
Integrated Network | 0.91 (0.89 to 0.92) | 1.00 (0.97 to 1.04) | 0.86 (0.84 to 0.88) | 0.96 (0.95 to 0.98) | 0.92 (0.90 to 0.94) | 0.91 (0.88 to 0.95) | 0.95 (0.94 to 0.95) |
Unknown | 2.34 (2.28 to 2.41) | 1.06 (0.99 to 1.12) | 5.01 (3.92 to 6.41) | 2.02 (1.96 to 2.07) | 0.81 (0.77 to 0.85) | 0.86 (0.80 to 0.92) | 0.92 (0.89 to 0.95) |
Region | |||||||
Northeast | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
Midwest | 1.06 (1.05 to 1.08) | 1.07 (1.05 to 1.10) | 1.04 (1.03 to 1.06) | 1.06 (1.05 to 1.07) | 1.12 (1.10 to 1.13) | 1.12 (1.09 to 1.14) | 1.08 (1.08 to 1.09) |
South | 1.01 (0.99 to 1.02) | 0.98 (0.96 to 1.00) | 1.04 (1.02 to 1.05) | 1.06 (1.05 to 1.07) | 1.10 (1.09 to 1.11) | 1.07 (1.05 to 1.09) | 1.04 (1.03 to 1.05) |
West | 0.94 (0.93 to 0.96) | 1.00 (0.97 to 1.03) | 0.95 (0.93 to 0.96) | 1.03 (1.02 to 1.05) | 1.07 (1.05 to 1.08) | 1.07 (1.05 to 1.10) | 1.06 (1.05 to 1.06) |
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Wang, F.; Shu, X.; Pal, T.; Berlin, J.; Nguyen, S.M.; Zheng, W.; Bailey, C.E.; Shu, X.-O. Racial/Ethnic Disparities in Mortality Related to Access to Care for Major Cancers in the United States. Cancers 2022, 14, 3390. https://doi.org/10.3390/cancers14143390
Wang F, Shu X, Pal T, Berlin J, Nguyen SM, Zheng W, Bailey CE, Shu X-O. Racial/Ethnic Disparities in Mortality Related to Access to Care for Major Cancers in the United States. Cancers. 2022; 14(14):3390. https://doi.org/10.3390/cancers14143390
Chicago/Turabian StyleWang, Fei, Xiang Shu, Tuya Pal, Jordan Berlin, Sang M. Nguyen, Wei Zheng, Christina E. Bailey, and Xiao-Ou Shu. 2022. "Racial/Ethnic Disparities in Mortality Related to Access to Care for Major Cancers in the United States" Cancers 14, no. 14: 3390. https://doi.org/10.3390/cancers14143390