- Black patients with esophageal cancer are significantly less likely than non-Hispanic whites (NHWs) to undergo surgery, which accounts for the higher mortality rate among black patients.
Why this matters
- Even when NHW patients had the same disease presentation as black patients, whites were more than twice as likely to undergo surgery than blacks.
- 17,423 patients newly diagnosed with esophageal adenocarcinoma (EAC, n=10,774) and esophageal squamous cell carcinoma (ESCC, n=6649; 10.9% black, 89.1% white) from the Surveillance Epidemiology and End Results database between 1994 and 2011 were included.
- Matched cohorts based on demographics, presentation, and treatment.
- Funding: None disclosed.
- Blacks were significantly less likely to receive surgery than NHWs, even after demographic and presentation matching (10.8% vs 22.8%; P<.001>
- Black race/ethnicity significantly associated with higher mortality when adjusted for demographics and presentation (black vs NHW, HR, 1.14; 95% CI, 1.03-1.25), but not when adjusted for treatment (HR, 1.04; 95% CI, 0.94-1.14).
- Type of surgery was not associated with survival disparity.
- When matched for presentation and adjusted for surgery, black race/ethnicity was not associated with mortality risk (HR, 1.05; 95% CI, 0.95-1.16).
- Findings based on claims data.