Scholarlink

Background <p>Racial and ethnic disparities in esophageal cancer outcomes are documented, but whether they differ by stage at diagnosis is unclear. Using population-based data from Florida, a diverse, Medicaid non-expansion state, we conducted a stage-stratified analysis of racial/ethnic differences in survival and treatment receipt.</p> Methods <p>We analyzed 21,814 esophageal cancer cases from the Florida Cancer Data System (2005–2021). Using cause-specific Cox models, we estimated adjusted hazard ratios (aHRs) for cancer-specific mortality overall and by stage, adjusting for demographics, tumor characteristics, treatment, smoking, and socioeconomic factors. Multivariable logistic regression assessed racial/ethnic differences in receipt of surgery, chemotherapy, and radiation.</p> Results <p>Patients were 81.0% non-Hispanic (NH) White, 8.0% NH Black, and 10.0% Hispanic. NH Black patients had higher overall mortality than NH White patients (aHR: 1.08; 95% CI 1.02–1.15). Stage-stratified models showed elevated mortality among NH Black patients at localized (aHR: 1.24; 95% CI 1.05–1.45) and regional stages (aHR: 1.19; 95% CI 1.07–1.35) compared with NH White patients, but lower mortality at distant stage (aHR: 0.88; 95% CI 0.80–0.98). NH Black patients had lower odds of surgery (aOR: 0.51; 95% CI 0.43–0.61) and chemotherapy (aOR: 0.79; 95% CI 0.70–0.90) compared&#xa0;with NH White patients; radiation receipt did not differ.</p> Conclusion <p>Survival disparities were most pronounced at curable stages, indicating inequities in post-diagnosis management. Lower treatment receipt and &#xa0;persistent&#xa0;survival differences after clinical adjustment suggest that structural and systemic factors contribute. These findings highlight a critical target for cancer control and underscore the need for system-level reforms to ensure equitable, stage-appropriate care.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Racial and ethnic disparities in esophageal cancer survival are greatest at curable stages: a population-based study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年6月30日

查看全文
  • Saurabh Kalra,
  • Cindy Medina Pabón,
  • Deepak Kalra,
  • WayWay M. Hlaing,
  • Paulo S. Pinheiro

摘要

Background

Racial and ethnic disparities in esophageal cancer outcomes are documented, but whether they differ by stage at diagnosis is unclear. Using population-based data from Florida, a diverse, Medicaid non-expansion state, we conducted a stage-stratified analysis of racial/ethnic differences in survival and treatment receipt.

Methods

We analyzed 21,814 esophageal cancer cases from the Florida Cancer Data System (2005–2021). Using cause-specific Cox models, we estimated adjusted hazard ratios (aHRs) for cancer-specific mortality overall and by stage, adjusting for demographics, tumor characteristics, treatment, smoking, and socioeconomic factors. Multivariable logistic regression assessed racial/ethnic differences in receipt of surgery, chemotherapy, and radiation.

Results

Patients were 81.0% non-Hispanic (NH) White, 8.0% NH Black, and 10.0% Hispanic. NH Black patients had higher overall mortality than NH White patients (aHR: 1.08; 95% CI 1.02–1.15). Stage-stratified models showed elevated mortality among NH Black patients at localized (aHR: 1.24; 95% CI 1.05–1.45) and regional stages (aHR: 1.19; 95% CI 1.07–1.35) compared with NH White patients, but lower mortality at distant stage (aHR: 0.88; 95% CI 0.80–0.98). NH Black patients had lower odds of surgery (aOR: 0.51; 95% CI 0.43–0.61) and chemotherapy (aOR: 0.79; 95% CI 0.70–0.90) compared with NH White patients; radiation receipt did not differ.

Conclusion

Survival disparities were most pronounced at curable stages, indicating inequities in post-diagnosis management. Lower treatment receipt and  persistent survival differences after clinical adjustment suggest that structural and systemic factors contribute. These findings highlight a critical target for cancer control and underscore the need for system-level reforms to ensure equitable, stage-appropriate care.