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

Miriam W. Tsao, Olivia M. Delozier, Zachary E. Stiles, Louis J. Magnotti, Stephen W. Behrman, Jeremiah L. Deneve, Evan S. Glazer, David Shibata, Danny Yakoub, Paxton V. Dickson

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)494-502
Number of pages9
JournalJournal of surgical oncology
Volume121
Issue number3
DOIs
StatePublished - Mar 1 2020
Externally publishedYes

Keywords

  • African American
  • disparities
  • stomach cancer

ASJC Scopus subject areas

  • Surgery
  • Oncology

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