Patterns of Care and Data Quality in a National Registry of Black and White Patients with Merkel Cell Carcinoma

被引:2
作者
Rattani, Abbas [1 ]
Gaskins, Jeremy [2 ]
McKenzie, Grant [3 ]
Scharf, Virginia Kate [4 ]
Broman, Kristy [5 ]
Pisu, Maria [6 ]
Holder, Ashley [5 ]
Dunlap, Neal [3 ]
Schwartz, David [7 ]
Yusuf, Mehran B. [8 ]
机构
[1] Tufts Univ, Dept Radiat Oncol, Med Ctr, Boston, MA 02111 USA
[2] Univ Louisville, Sch Publ Hlth & Informat Sci, Dept Bioinformat & Biostat, Louisville, KY 40202 USA
[3] Univ Louisville, Brown Canc Ctr, Dept Radiat Oncol, Sch Med, Louisville, KY 40202 USA
[4] Univ Louisville, Sch Med, Louisville, KY 40202 USA
[5] Univ Alabama Birmingham, Dept Surg, Div Surg Oncol, Birmingham, AL 35294 USA
[6] Univ Alabama Birmingham, Dept Med, Birmingham, AL 35294 USA
[7] Univ Tennessee, Dept Radiat Oncol, Hlth Sci Ctr, Memphis, TN 38163 USA
[8] Univ Alabama Birmingham, Dept Radiat Oncol, ONeal Comprehens Canc Ctr, Sch Med, Birmingham, AL 35294 USA
关键词
Merkel Cell Carcinoma; race; epidemiology; SURVIVAL; EPIDEMIOLOGY; CANCER; RACE;
D O I
10.3390/cancers14205059
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Simple Summary Merkel Cell Carcinoma is a rare skin cancer most commonly affecting White patients. Less is known for Black patients. We aimed to report presentation, treatment, and quality of registry data by race with a secondary endpoint of overall survival. Findings from this work aim to impact patient and provider awareness to further equitable access to optimal cancer care across the spectrum from diagnosis and treatment to post-therapy surveillance for patients with Merkel Cell Carcinoma. Merkel Cell Carcinoma (MCC) is a rare cancer most commonly affecting White patients; less is known for Black patients. We aim to report presentation, treatment, and quality of registry data by race with a secondary endpoint of overall survival. We conducted a retrospective cohort analysis between 2006-2017 via the National Cancer Database of Black and White MCC patients with and without known staging information. Multivariable logistic, proportional odds logistic, and baseline category logistic regression models were used for our primary endpoint. Multivariable Cox regression was used to interrogate overall survival. Multiple imputation was used to mitigate missing data bias. 34,503 patients with MCC were included (2566 Black patients). Black patients were younger (median age 52 vs. 72, p < 0.0001), had higher rates of immunosuppression (28% vs. 14%, p = 0.0062), and were more likely to be diagnosed at a higher stage (proportional OR = 1.41, 95% CI 1.25-1.59). No differences were noted by race across receipt of definitive resection (DR), though Black patients did have longer time from diagnosis to DR. Black patients were less likely to receive adjuvant radiation. Black patients were more likely to have missing cancer stage (OR = 1.69, CI 1.52-1.88). Black patients had decreased adjusted risk of mortality (HR 0.73, 0.65-0.81). Given the importance of registry analyses for rare cancers, efforts are needed to ensure complete data coding. Paramount to ensuring equitable access to optimal care for all is the recognition that MCC can occur in Black patients.
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页数:14
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