@article{2794d066cd7a4679958476b80b7c80b5,
title = "Racial Disparities in Time to Treatment Initiation and Outcomes for Early Stage Anal Squamous Cell Carcinoma",
abstract = "Objectives:Although cure rates for early stage anal squamous cell cancer (ASCC) are overall high, there may be racial disparities in receipt of treatment and outcome precluding favorable outcomes across all patient demographics. Therefore, the authors aimed to assess the time to treatment initiation and overall survival (OS) in Black and White patients receiving definitive chemoradiation for early stage ASCC.Materials and Methods:The authors identified patients diagnosed with early stage (stage I-II) ASCC and treated with chemoradiation diagnosed between 2004 and 2016 in the National Cancer Database. Clinical and treatment variables were compared by race using the χ2 test, and OS assessed through Cox regression with 1:1 nearest neighbor propensity score matching.Results:Among 9331 patients, 90.6% were White. Black patients had longer median time to treatment initiation as compared with White patients (47 vs. 36 d, P<0.001), and on multivariable analysis, the Black race was associated with higher odds of >6 weeks of time to treatment initiation (hazard ratio, 1.78; 95% confidence interval, 1.53-2.08; P<0.001). Furthermore, Black patients had worse OS (5-year survival 71% vs. 77%; P<0.001), which persisted after propensity score matching (P=0.007).Conclusions:Black patients had a longer time to treatment initiation and worse OS as compared with White patients with early stage ASCC treated with chemoradiation. Further research is needed to better elucidate the etiologies of these disparities.",
keywords = "anal neoplasms, healthcare disparities, propensity score, race factors, time to treatment",
author = "Goksu, {Suleyman Y.} and Muhammet Ozer and Kazmi, {Syed M.A.} and Aguilera, {Todd A.} and Chul Ahn and David Hsieh and Aravind Sanjeevaiah and Maxwell, {Mary C.} and Beg, {Muhammad S.} and Sanford, {Nina N.}",
note = "Funding Information: NCI Cancer Center Support Grant to UT Southwestern Medical Center (5P30CA142543-07) to Muhammad Beg. The research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR001105. Muhammad Beg is Designated Dedman Family Scholar in Clinical Care. Funding Information: From the *Division of Hematology and Oncology; ‡Department of Radiation Oncology; §Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX; and †Department of Internal Medicine, Capital Health Regional Medical Center, NJ. S.Y.G., M.O., C.A., S.M.A.K., M.S.B., and N.N.S.: conception, design, analysis, and interpretation of data. All authors: drafting, revision, and final approval of manuscript. This manuscript has been presented as an abstract form for the 2020 American Society of Clinical Oncology Annual Meeting. NCI Cancer Center Support Grant to UT Southwestern Medical Center (5P30CA142543-07) to Muhammad Beg. The research reported in this publication was supported by the National Center for Advancing Trans-lational Sciences of the National Institutes of Health under Award Number UL1TR001105. Muhammad Beg is Designated Dedman Family Scholar in Clinical Care. The authors declare no conflicts of interest. Reprints: Nina N. Sanford, MD, Department of Radiation Oncology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390. E-mail: nina.sanford@utsouthwestern.edu. Copyright {\textcopyright} 2020 Wolters Kluwer Health, Inc. All rights reserved. ISSN: 0277-3732/20/4311-0762 DOI: 10.1097/COC.0000000000000744 Publisher Copyright: {\textcopyright} 2020 Wolters Kluwer Health, Inc. All rights reserved.",
year = "2020",
month = nov,
day = "1",
doi = "10.1097/COC.0000000000000744",
language = "English (US)",
volume = "43",
pages = "762--769",
journal = "American Journal of Clinical Oncology: Cancer Clinical Trials",
issn = "0277-3732",
publisher = "Lippincott Williams and Wilkins",
number = "11",
}