Characterizing gastric cancer and time-to-first treatment among non-Hispanic American Indian Alaska Native and white patients in North Carolina.
This study aimed to characterize the gastric cancer burden among non-Hispanic American Indian Alaska Native (NHAIAN) and White (NHW) individuals in North Carolina to provide a baseline assessment of the gastric cancer burden in North Carolina.
Data from the North Carolina Central Cancer Registry (2003-2021) were used to construct gastric cancer diagnosis (NHAIAN n = 111; NHW n = 7,685) and treatment (NHAIAN n = 97; NHW n = 6,040) cohorts. Race-stratified patient characteristics were summarized. We evaluated unadjusted associations between patient characteristics and receipt of no treatment and the multivariable-adjusted association risk ratio (RR) between race and no treatment using modified Poisson regression. Race-specific cumulative incidence functions (CIFs) for treatment initiation were estimated with bootstrapped 95% confidence intervals (CI) and adjusted for key covariates using inverse probability weighting.
NHAIANs were diagnosed at a younger age (65 vs 68 years; p = 0.006), with non-cardia cancer (80 vs 62%; p < 0.001), at a later stage (36 vs 32%; p = 0.021), and lived in an area with a lower residential population density than NHW gastric cancer patients (76 vs 26%; p < 0.001). The risk of not initiating treatment was higher among NHAIANs compared to NHWs (RR = 1.13 (95% CI = [0.87, 1.47]; p= 0.34). The CIF for treatment initiation was consistently lower for NHAIANs with a significant difference at 30 days (CIF difference = -0.09; 95% CI = [-0.17, -0.01]).
NHAIAN gastric cancer patients in North Carolina were diagnosed younger, at more advanced stages, and had a lower cumulative probability of initiating treatment within the first year after diagnosis compared to NHWs.
Data from the North Carolina Central Cancer Registry (2003-2021) were used to construct gastric cancer diagnosis (NHAIAN n = 111; NHW n = 7,685) and treatment (NHAIAN n = 97; NHW n = 6,040) cohorts. Race-stratified patient characteristics were summarized. We evaluated unadjusted associations between patient characteristics and receipt of no treatment and the multivariable-adjusted association risk ratio (RR) between race and no treatment using modified Poisson regression. Race-specific cumulative incidence functions (CIFs) for treatment initiation were estimated with bootstrapped 95% confidence intervals (CI) and adjusted for key covariates using inverse probability weighting.
NHAIANs were diagnosed at a younger age (65 vs 68 years; p = 0.006), with non-cardia cancer (80 vs 62%; p < 0.001), at a later stage (36 vs 32%; p = 0.021), and lived in an area with a lower residential population density than NHW gastric cancer patients (76 vs 26%; p < 0.001). The risk of not initiating treatment was higher among NHAIANs compared to NHWs (RR = 1.13 (95% CI = [0.87, 1.47]; p= 0.34). The CIF for treatment initiation was consistently lower for NHAIANs with a significant difference at 30 days (CIF difference = -0.09; 95% CI = [-0.17, -0.01]).
NHAIAN gastric cancer patients in North Carolina were diagnosed younger, at more advanced stages, and had a lower cumulative probability of initiating treatment within the first year after diagnosis compared to NHWs.
Authors
Uhrin Uhrin, Jackson Jackson, Baggett Baggett, Spees Spees, Begay Begay, Epplein Epplein, Wheeler Wheeler, Bell Bell, Emerson Emerson
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