PMID- 36695990
OWN - NLM
STAT- MEDLINE
DCOM- 20230613
LR  - 20231117
IS  - 1534-4681 (Electronic)
IS  - 1068-9265 (Linking)
VI  - 30
IP  - 7
DP  - 2023 Jul
TI  - Racial Segregation Among Patients with Cholangiocarcinoma-Impact on Diagnosis, 
      Treatment, and Outcomes.
PG  - 4238-4246
LID - 10.1245/s10434-023-13122-1 [doi]
AB  - BACKGROUND: Racial segregation, an effect of historical marginalization, may 
      impact cancer care and outcomes. We sought to examine the impact of racial 
      segregation on the diagnosis, treatment, and outcomes of patients with 
      cholangiocarcinoma (CCA). PATIENTS AND METHODS: Data on Black and White patients 
      with CCA were obtained from the linked SEER-Medicare database (2004-2015) and 
      2010 Census data. The index of dissimilarity (IoD), a validated measure of 
      segregation, was used to assess Black-White disparities in stage disease 
      presentation, surgery for localized disease, and cancer-specific mortality. 
      Multivariable Poisson regression was performed, and competing risk regression 
      analysis was used to determine cancer-specific survival. RESULTS: Among 7480 
      patients with CCA, 90.2% (n = 6748) were White and 9.8% (n = 732) were Black. 
      Overall, Black patients were more likely to reside in segregated areas compared 
      with White patients (IoD, 0.42 vs. 0.38; p < 0.05). On multivariable Poisson 
      regression, Black patients were more likely to present with advanced-stage 
      disease [relative risk (RR) 1.17, 95% confidence interval (CI) 1.08-1.27; p < 
      0.001] and were less likely to undergo surgery for localized disease (RR 0.62, 
      95% CI 0.51-0.76; p < 0.001). Black patients also had worse cancer-specific 
      survival (CSS) compared with White patients (median CSS: 4 vs. 8 months; p < 
      0.01). Black patients living in the highest areas of segregation had 40% 
      increased hazard of mortality versus White patients residing in the lowest IoD 
      areas (hazard ratio 1.40, 95% CI 1.10-1.80; p < 0.01). CONCLUSION: Racial 
      segregation, as a proxy for structural racism, had a marked effect on Black-White 
      disparities among patients with CCA.
CI  - (c) 2023. Society of Surgical Oncology.
FAU - Munir, Muhammad Musaab
AU  - Munir MM
AD  - Department of Surgery, The Ohio State University Wexner Medical Center, James 
      Comprehensive Cancer Center, Columbus, OH, USA.
FAU - Woldesenbet, Selamawit
AU  - Woldesenbet S
AD  - Department of Surgery, The Ohio State University Wexner Medical Center, James 
      Comprehensive Cancer Center, Columbus, OH, USA.
FAU - Endo, Yutaka
AU  - Endo Y
AD  - Department of Surgery, The Ohio State University Wexner Medical Center, James 
      Comprehensive Cancer Center, Columbus, OH, USA.
FAU - Lima, Henrique A
AU  - Lima HA
AD  - Department of Surgery, The Ohio State University Wexner Medical Center, James 
      Comprehensive Cancer Center, Columbus, OH, USA.
FAU - Alaimo, Laura
AU  - Alaimo L
AD  - Department of Surgery, The Ohio State University Wexner Medical Center, James 
      Comprehensive Cancer Center, Columbus, OH, USA.
FAU - Moazzam, Zorays
AU  - Moazzam Z
AD  - Department of Surgery, The Ohio State University Wexner Medical Center, James 
      Comprehensive Cancer Center, Columbus, OH, USA.
FAU - Shaikh, Chanza
AU  - Shaikh C
AD  - Department of Surgery, The Ohio State University Wexner Medical Center, James 
      Comprehensive Cancer Center, Columbus, OH, USA.
FAU - Cloyd, Jordan
AU  - Cloyd J
AD  - Department of Surgery, The Ohio State University Wexner Medical Center, James 
      Comprehensive Cancer Center, Columbus, OH, USA.
FAU - Ejaz, Aslam
AU  - Ejaz A
AD  - Department of Surgery, The Ohio State University Wexner Medical Center, James 
      Comprehensive Cancer Center, Columbus, OH, USA.
FAU - Azap, Rosevine
AU  - Azap R
AD  - Department of Surgery, The Ohio State University Wexner Medical Center, James 
      Comprehensive Cancer Center, Columbus, OH, USA.
FAU - Azap, Lovette
AU  - Azap L
AD  - Department of Surgery, The Ohio State University Wexner Medical Center, James 
      Comprehensive Cancer Center, Columbus, OH, USA.
FAU - Pawlik, Timothy M
AU  - Pawlik TM
AUID- ORCID: 0000-0002-7994-9870
AD  - Department of Surgery, The Ohio State University Wexner Medical Center, James 
      Comprehensive Cancer Center, Columbus, OH, USA. Tim.Pawlik@osumc.edu.
AD  - Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer 
      Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA. 
      Tim.Pawlik@osumc.edu.
LA  - eng
PT  - Journal Article
DEP - 20230125
PL  - United States
TA  - Ann Surg Oncol
JT  - Annals of surgical oncology
JID - 9420840
SB  - IM
CIN - Ann Surg Oncol. 2023 Jul;30(7):4247-4248. PMID: 36705814
MH  - Aged
MH  - Humans
MH  - Black or African American
MH  - *Cholangiocarcinoma/diagnosis/therapy
MH  - Medicare
MH  - Proportional Hazards Models
MH  - *Social Segregation
MH  - United States/epidemiology
MH  - White
MH  - *Healthcare Disparities
MH  - Systemic Racism
MH  - *Health Status Disparities
EDAT- 2023/01/26 06:00
MHDA- 2023/06/12 06:42
CRDT- 2023/01/25 11:20
PHST- 2022/10/25 00:00 [received]
PHST- 2023/01/02 00:00 [accepted]
PHST- 2023/06/12 06:42 [medline]
PHST- 2023/01/26 06:00 [pubmed]
PHST- 2023/01/25 11:20 [entrez]
AID - 10.1245/s10434-023-13122-1 [pii]
AID - 10.1245/s10434-023-13122-1 [doi]
PST - ppublish
SO  - Ann Surg Oncol. 2023 Jul;30(7):4238-4246. doi: 10.1245/s10434-023-13122-1. Epub 
      2023 Jan 25.