1429P - Differences in esophageal cancer incidence and survival by race/ethnicity: A SEER analysis

Background

There is a limited understanding of racial disparities in esophageal cancer prevalence, treatment, and mortality within the U.S.

Methods

We analyzed American patients with esophageal cancer from 2004-2020 for five racial/ethnic groups (non-Hispanic White (White), White Hispanic (Hispanic), Black, Asian/Pacific Islander, and American Indian/Alaskan Native) using the Surveillance, Epidemiology, and End Results (SEER) registry, a large, nationally representative dataset.

Results

A total of 59,573 patient records were included in this analysis (76% White, 10% Black, 8% Hispanic, 5% Asian, 1% American Indian/Alaskan Native). Significant variation in tumor histology was observed across races: 78% of Black and 68% of Asian patients had squamous cell carcinoma compared to 25% of White and 36% of Hispanic patients (p < 0.0001). There was significant variation in T stage at diagnosis by race (p < 0.0001). While both White and Black patients had equal rates of T1 diagnosis (24% each), Black patients were more frequently diagnosed as T4 (18%, compared to 10% for White patients). Primary tumor location varied significantly by race, with 64% and 53% of White and Hispanic patients having a primary tumor in the lower third of the esophagus, compared to 33% and 40% of Black and Asian patients (p < 0.0001). Distribution of treatment options significantly differed across races (p < 0.0001). 29% of Black and 28% of Hispanic patients received no treatment compared to 25% of White and 25% of Asian patients. Furthermore, White patients received trimodal therapy (chemotherapy, radiation, and surgery) more frequently than Black patients (15% vs. 6%, respectively). Compared to White patients, significant differences in survival were observed for Asian patients, who had improved survival (HR = 0.91, p < 0.0001), and Black patients who had poorer survival (HR = 1.16, p < 0.0001).

Conclusions

Our analysis reveals significant racial and ethnic disparities in esophageal cancer incidence, tumor characteristics, treatment patterns, and survival, underscoring the need for targeted interventions which improve outcomes for all patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.