Impact of race and ethnicity on treatment and survival of women with vulvar cancer in the United States

Ana I. Tergas, Jill H. Tseng, Robert E. Bristow

Research output: Contribution to journalArticle

Abstract

Objective To examine racial/ethnic differences in treatment and survival in women diagnosed with invasive vulvar cancer in the United States. Methods Women with invasive vulvar cancer were identified from the Surveillance, Epidemiology, and End Results database from 1/1/92 to 12/31/02. Statistical analysis using Chi-square, Fisher's Exact Test, Kaplan-Meier survival methods, and Cox regression proportional hazards models was performed. Results Of the 2357 cases of invasive vulvar cancer included in this study, 1974 (83.8%) were non-Hispanic white, 209 (8.9%) were non-Hispanic black, 119 (5.0%) were Hispanic, and 55 (2.3%) women were of another race/ethnicity. After adjustment for stage, black women were half as likely (OR = 0.48, 95% CI 0.31-0. 74) to undergo surgery and 1.7 times more likely (OR = 1.67, 95% CI 1.18-2.36) to receive radiation than white women. In multivariable analysis, surgical treatment reduced the risk of death from vulvar cancer by 46% (HR 0.54, 95% CI 0.43-0.67), whereas radiation was not shown to impact the risk of death (HR 0.99, 95% CI 0.84-1.19), after adjusting for age, race, stage, and grade. There was no significant difference in risk of death by race/ethnicity group after adjusting for the previously described variables. Conclusions Based on this study, race/ethnicity is not an independent risk factor for poor prognosis in women diagnosed with invasive vulvar cancer, despite differences in treatment modality by race/ethnicity. Further research to define the factors contributing to differences in treatment selection according to race/ethnicity and the resulting impact on quality of life is warranted.

Original languageEnglish (US)
Pages (from-to)154-158
Number of pages5
JournalGynecologic Oncology
Volume129
Issue number1
DOIs
StatePublished - Apr 2013
Externally publishedYes

Fingerprint

Vulvar Neoplasms
Survival
Therapeutics
Radiation
Kaplan-Meier Estimate
Hispanic Americans
Proportional Hazards Models
Epidemiology
Quality of Life
Databases
Research

Keywords

  • Healthcare disparities
  • Racial disparities
  • SEER database
  • Survival analysis
  • Vulvar cancer

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Impact of race and ethnicity on treatment and survival of women with vulvar cancer in the United States. / Tergas, Ana I.; Tseng, Jill H.; Bristow, Robert E.

In: Gynecologic Oncology, Vol. 129, No. 1, 04.2013, p. 154-158.

Research output: Contribution to journalArticle

Tergas, Ana I. ; Tseng, Jill H. ; Bristow, Robert E. / Impact of race and ethnicity on treatment and survival of women with vulvar cancer in the United States. In: Gynecologic Oncology. 2013 ; Vol. 129, No. 1. pp. 154-158.
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abstract = "Objective To examine racial/ethnic differences in treatment and survival in women diagnosed with invasive vulvar cancer in the United States. Methods Women with invasive vulvar cancer were identified from the Surveillance, Epidemiology, and End Results database from 1/1/92 to 12/31/02. Statistical analysis using Chi-square, Fisher's Exact Test, Kaplan-Meier survival methods, and Cox regression proportional hazards models was performed. Results Of the 2357 cases of invasive vulvar cancer included in this study, 1974 (83.8{\%}) were non-Hispanic white, 209 (8.9{\%}) were non-Hispanic black, 119 (5.0{\%}) were Hispanic, and 55 (2.3{\%}) women were of another race/ethnicity. After adjustment for stage, black women were half as likely (OR = 0.48, 95{\%} CI 0.31-0. 74) to undergo surgery and 1.7 times more likely (OR = 1.67, 95{\%} CI 1.18-2.36) to receive radiation than white women. In multivariable analysis, surgical treatment reduced the risk of death from vulvar cancer by 46{\%} (HR 0.54, 95{\%} CI 0.43-0.67), whereas radiation was not shown to impact the risk of death (HR 0.99, 95{\%} CI 0.84-1.19), after adjusting for age, race, stage, and grade. There was no significant difference in risk of death by race/ethnicity group after adjusting for the previously described variables. Conclusions Based on this study, race/ethnicity is not an independent risk factor for poor prognosis in women diagnosed with invasive vulvar cancer, despite differences in treatment modality by race/ethnicity. Further research to define the factors contributing to differences in treatment selection according to race/ethnicity and the resulting impact on quality of life is warranted.",
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AB - Objective To examine racial/ethnic differences in treatment and survival in women diagnosed with invasive vulvar cancer in the United States. Methods Women with invasive vulvar cancer were identified from the Surveillance, Epidemiology, and End Results database from 1/1/92 to 12/31/02. Statistical analysis using Chi-square, Fisher's Exact Test, Kaplan-Meier survival methods, and Cox regression proportional hazards models was performed. Results Of the 2357 cases of invasive vulvar cancer included in this study, 1974 (83.8%) were non-Hispanic white, 209 (8.9%) were non-Hispanic black, 119 (5.0%) were Hispanic, and 55 (2.3%) women were of another race/ethnicity. After adjustment for stage, black women were half as likely (OR = 0.48, 95% CI 0.31-0. 74) to undergo surgery and 1.7 times more likely (OR = 1.67, 95% CI 1.18-2.36) to receive radiation than white women. In multivariable analysis, surgical treatment reduced the risk of death from vulvar cancer by 46% (HR 0.54, 95% CI 0.43-0.67), whereas radiation was not shown to impact the risk of death (HR 0.99, 95% CI 0.84-1.19), after adjusting for age, race, stage, and grade. There was no significant difference in risk of death by race/ethnicity group after adjusting for the previously described variables. Conclusions Based on this study, race/ethnicity is not an independent risk factor for poor prognosis in women diagnosed with invasive vulvar cancer, despite differences in treatment modality by race/ethnicity. Further research to define the factors contributing to differences in treatment selection according to race/ethnicity and the resulting impact on quality of life is warranted.

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