Incidence and survival differences in esophageal cancer among ethnic groups in the United States
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Zheling Chen1, Yinghong Ren2, Xianglin L. Du3, Jiao Yang1, Yanwei Shen1, Shuting Li1, Yunying Wu1, Meng Lv1, Danfeng Dong1, Enxiao Li1, Wei Li4, Peijun Liu5, Jin Yang1 and Min Yi1,6
1Department of Medical Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
2Department of Internal Medicine, Shangluo Central Hospital, Shangluo, Shaanxi, People’s Republic of China
3Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas School of Public Health, Houston, TX, USA
4Weapon Industry Health Research Institute, Xian, Shaanxi, People’s Republic of China
5Department of Translational Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
6Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Min Yi, email: email@example.com
Jin Yang, email: firstname.lastname@example.org
Keywords: esophageal cancer, the united states, survival, incidence rate, ethnicity
Received: February 12, 2017 Accepted: March 06, 2017 Published: March 30, 2017
Objectives: This study was performed to identify the differences in incidence, clinicopathological features, and survival in esophageal cancer among ethnic groups in the United States and to determine the reasons for the differences.
Result: A total of 49,766 patients were included. Black and Asian groups had a higher proportion of squamous cell carcinoma (ESCC) (85.5% and 75.4%, respectively) and mid-esophagus tumor (43.2% and 37.7% respectively) than the non-Hispanic white and Hispanic white groups. The incidences of ESCC in all ethnic groups declined since 1973, especially in black males. At the same time, incidences of esophageal adenocarcinoma (EAC) dramatically increased in white males since 1973. And incidences of ESCC and EAC were the lowest and stable in Asian female. Multivariable models showed that patients who were male, or black, or had larger tumors, or positive lymph nodes had an increased risk of death from esophageal cancer, while patients with ESCC or diagnosed after 2005 or treated with surgery had a lower likelihood of death. For ESCC, the black patients had the lowest DSS, while for EAC there were no significant differences in DSS among the ethnic/racial groups.
Materials and Method: From the Surveillance, Epidemiology, and End Results Program database, patients diagnosed with esophageal cancer from 1998-2013 were identified. Differences in incidences, clinicopathological features, treatments, and disease-specific survival (DSS) in four broad racial/ethnic groups were compared.
Conclusion: Histological type distribution between racial groups could be an important consideration in the incidence and the survival trend but other factors could also have an effect.
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