Disparities in Kaposi sarcoma incidence and survival in the United States: 2000-2013

被引:45
作者
Royse, Kathryn E. [1 ]
El Cheer, Firas [2 ,3 ]
Amirian, E. Susan [4 ,5 ]
Hartman, Christine [1 ]
Krown, Susan E. [6 ]
Uldrick, Thomas S. [7 ]
Lee, Jeannette Y. [8 ]
Shepard, Zachary [9 ]
Chiao, Elizabeth Y. [1 ,2 ]
机构
[1] Michael E DeBakey VA Med Ctr, Ctr Innovat Qual Effectiveness & Safety, Houston, TX 77030 USA
[2] Baylor Coll Med, Dept Med, Sect Infect Dis, Houston, TX 77030 USA
[3] Univ Texas MD Anderson Canc Ctr, Dept Infect Dis Infect Control & Employee Hlth, Houston, TX 77030 USA
[4] Baylor Coll Med, Dan L Duncan Canc Ctr, Houston, TX 77030 USA
[5] Baylor Coll Med, Dept Pediat, Houston, TX 77030 USA
[6] AIDS Malignancy Consortium, New York, NY USA
[7] NCI, HIV & AIDS Malignancy Branch, NIH, Bethesda, MD 20892 USA
[8] Univ Arkansas Med Sci, Dept Biostat, Little Rock, AR 72205 USA
[9] Baylor Coll Med, Dept Undergrad Educ, Houston, TX 77030 USA
基金
美国国家卫生研究院;
关键词
CANCER INCIDENCE; AIDS; HIV; EPIDEMIOLOGY; PEOPLE;
D O I
10.1371/journal.pone.0182750
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Objective Geographic and racial disparities may contribute to variation in the incidence and outcomes of HIV-associated cancers in the United States. Method Using the Surveillance, Epidemiology, and End Results (SEER) database, we analyzed Kaposi sarcoma (KS) incidence and survival by race and geographic region during the combined antiretroviral therapy era. Reported cases of KS in men from 2000 to 2013 were obtained from 17 SEER cancer registries. Overall and age-standardized KS incidence rates were calculated and stratified by race and geographic region. We evaluated incidence trends using joinpoint analyses and calculated adjusted hazard ratios (aHR) for overall and KS-specific mortality using multivariable Cox proportional hazards models. Results Of 4,455 KS cases identified in men younger than 55 years (median age 40 years), the annual percent change (APC) for KS incidence significantly decreased for white men between 2001 and 2013 (APC -4.52, p = 0.02). The APC for AA men demonstrated a nonsignificant decrease from 2000-2013 (APC -1.84, p = 0.09). Among AA men in the South, however, APC has significantly increased between 2000 and 2013 (+3.0, p = 0.03). In addition, compared with white men diagnosed with KS during the same time period, AA men were also more likely to die from all causes and KS cancer-specific causes (aHR 1.52, 95% CI 1.34-1.72, aHR 1.49, 95% CI 1.30-1.72 respectively). Conclusion Although overall KS incidence has decreased in the U.S., geographic and racial disparities in KS incidence and survival exist.
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页数:12
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