Hispanics diagnosed with esophageal cancer are less likely to undergo surgery for potentially resectable disease, and, as a result, have a decreased survival rate compared with white patients, according to a study of Surveillance, Epidemiology, and End Results (SEER) data.1
Researchers identified 22,531 cases of esophageal cancer in Hispanics (9%) and whites (91%) taken from the SEER database between 2003 and 2014. Of these, 6250 patients had locoregional disease.
Compared with white patients, Hispanic patients were younger at presentation and had lower-grade tumors, but were more likely to have distant metastases.
Hispanic patients had an 11% higher unadjusted risk for death compared with white patients (HR, 1.11; 95% CI, 1.06-1.17; P <.001), and a 2-month lower overall survival (10 vs 12 months; P <.05). Among Hispanics with locoregional disease, there was a 15% higher unadjusted risk for death compared with white patients (HR, 1.15; 95% CI, 1.03-1.29; P =.01).
These differences occurred “despite favorable associations with socioeconomic factors, including lower rates of tobacco use, higher average incomes, and higher educational attainment among Hispanics with esophageal cancer, all major lifestyle factors associated with decreased incidence.”
After adjusting for demographic and tumor characteristics, the researchers found that undergoing surgery for locoregional disease had a significant interaction with race on overall mortality (P =.01). Compared with 60% of white patients with locoregional disease, only 46% of Hispanic patients with locoregional disease received surgery (P <.001), and not receiving surgery was associated with a significantly lower overall survival (HR, 2.84; 95% CI, 2.65-3.04; P <.001).
- Gupta DR, Liu Y, Jiang R, et al. Racial disparities, outcomes, and surgical utilization among Hispanics with esophageal cancer: a Surveillance, Epidemiology, and End Results program database analysis . Oncology. doi: 10.1159/000499716