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RacialEthnic Disparities in Cancer Incidence, Survival and Treatment

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Age-Adjusted US Mortality Rates for the Most Common Cancers ... Documented Time Elapsed Since Last Mammogram for Women Age 40 and Older by Racial/Ethnic Group ... – PowerPoint PPT presentation

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Title: RacialEthnic Disparities in Cancer Incidence, Survival and Treatment


1
Racial/Ethnic Disparities in Cancer Incidence,
Survival and Treatment
  • Linda C. Harlan, PhD, MPH
  • National Cancer Institute
  • Division of Cancer Control and Population Sciences

2
Disparities in Cancer
  • Age
  • Gender
  • Marital Status
  • Income
  • Education
  • Insurance
  • Health System Characteristics
  • Geographic
  • Race/Ethnicity

3
Age-Adjusted US Mortality Rates for the Most
Common Cancers by Race/Ethnicity for 2000-2003
Source US population NCHS
4
Racial/Ethnic Disparities Along the Cancer
Continuum
  • Incidence
  • Screening
  • Stage at Diagnosis
  • Therapy
  • Survival

5
Age-Adjusted Incidence Rates for the Most Common
Cancers by Race/Ethnicity for 2000-2003
Source SEER
6
Percentage of Women Age 40 and Older Reporting
Having Mammography in the Past Two Years
Source NCHS
7
Documented Time Elapsed Since Last Mammogram for
Women Age 40 and Older by Racial/Ethnic Group
Adjusted for age and registry
Source Smith-Bindman, 2006
8
SEER Data
  • Population-Based Registries
  • Register all cancer cases within a geographic
    areas
  • 26 of the US population
  • Detailed data on
  • Demographics
  • Tumor characteristic
  • Treatment
  • Active follow-up of cases
  • Public use files, available to researchers
  • Analysis program associated with data

9
Stage at Diagnosis of In Situ and Invasive Breast
Cancer by Race/Ethnicity for Cases Diagnosed in
2000-2003
Source SEER
10
5-year Cancer-Specific Survival by Race/Ethnicity
and Stage for Invasive Breast Cancer Patients
Diagnosed Between 1990 -2002
Source SEER
11
Percentage of Women Receiving Radiation Following
Breast Conserving Surgery by Racial/Ethnicity and
Year of Diagnosis
Tumor lt 5cm Source SEER
12
Percent of Breast Cancer Cases Receiving
Radiation Following BCS by Race/Ethnicity and
County Family Poverty Rate 2000-2003
Source SEER
Families at or Below Poverty Level
13
Use of Adjuvant Chemo/Hormonal Therapy for Early
Stage, Node Negative Breast Cancer by
Race/Ethnicity, and ER status 2000
Source Harlan unpublished
ER negative
ER positive
14
Adjusted Percentage of Patients Diagnosed 1995
through 1999 Receiving Guideline Therapy by
Insurance Status and Race/Ethnicity
Charlson score, stage, number of positive lymph
nodes, residency training program, hospital bed
size, age, marital status, high school diploma,
gender, geographic region
Source Harlan, 2005
15
Summary
  • Racial/ethnic disparities occur across the cancer
    continuum
  • Screening
  • Stage at diagnosis
  • Treatment
  • Survival

16
Data Sources
  • Surveillance, Epidemiology and End-Results Data
  • http//seer.cancer.gov/seerstat/
  • Demographic, tumor characteristic, surgery and
    radiation
  • Active follow-up for vital status
  • SEER-Medicare linked file
  • http//healthservices.cancer.gov/seermedicare/obta
    in/
  • Cancer cases age 65 and a 5 sample of
    non-cancer patients
  • SEER data
  • Treatment data, long-term medical follow-up,
    procedures
  • Breast Cancer Surveillance Consortium
  • Mammography registries
  • http//breastscreening.cancer.gov/work/proposal_da
    ta.html
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