Ewing sarcoma demonstrates racial disparities in incidence-related and sex-related differences in outcome

An analysis of 1631 cases from the SEER database, 1973-2005

Muhammad U. Jawad, Michael C. Cheung, Elijah S. Min, Michaela M. Schneiderbauer, Leonidas Koniaris, Sean P. Scully

Research output: Contribution to journalArticle

112 Citations (Scopus)

Abstract

BACKGROUND: Previous reports of Ewing sarcoma cohorts suggested that there is a difference in incidence according to racial origin. However, to the authors' knowledge, this finding has never been tested in a population-based database, and the impact of race on clinical outcome and the significance of known risk factors stratified to racial groups have not been reported. METHODS: Patients who had Ewing sarcoma diagnosed between 1973 and 2005 were identified in the Surveillance, Epidemiology, and End Results database. Patient demographic and clinical characteristics; incidence; year of diagnosis; tumor location, tumor size, and disease stage at diagnosis; treatment(s); cause of death; and survival were extracted. Kaplan-Meier, log-rank, and Cox regressions were used to analyze the significance of prognostic factors. RESULTS: Race-specific incidence indicated that Caucasians have the highest incidence (0.155), followed by Asians/Pacific Islanders (0.082), and African Americans (0.017). The difference in incidence between Caucasians and African Americans was 9-fold and significant (P <.001). The incidence of Ewing sarcoma increased over the past 3 decades among Caucasians (P <.05). Survival was not impacted by race. Local disease stage, primary tumor location in the appendicular skeleton, and tumor size ≤8 cm conferred a significant survival benefit. Women demonstrated improved survival among the Caucasian patients (P <.03). CONCLUSIONS: To the authors' knowledge, this is the first report focusing on racial disparity in incidence of Ewing sarcoma. Caucasians were affected more frequently, although outcomes were similar between races. It is noteworthy that being a woman constituted a survival benefit only among the Caucasian patients. Further studies will need to clarify the reasons for racial disparities in incidence and for sex differences in survival.

Original languageEnglish (US)
Pages (from-to)3526-3536
Number of pages11
JournalCancer
Volume115
Issue number15
DOIs
StatePublished - Aug 1 2009
Externally publishedYes

Fingerprint

Ewing's Sarcoma
Sex Characteristics
Databases
Incidence
Survival
African Americans
Neoplasms
Oceanic Ancestry Group
Skeleton
Cause of Death
Epidemiology
Demography

Keywords

  • Cancer registries
  • End results program
  • Epidemiology
  • Incidence patterns
  • Prognostic factors
  • Racial origin
  • Sex distribution
  • Surveillance

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Ewing sarcoma demonstrates racial disparities in incidence-related and sex-related differences in outcome : An analysis of 1631 cases from the SEER database, 1973-2005. / Jawad, Muhammad U.; Cheung, Michael C.; Min, Elijah S.; Schneiderbauer, Michaela M.; Koniaris, Leonidas; Scully, Sean P.

In: Cancer, Vol. 115, No. 15, 01.08.2009, p. 3526-3536.

Research output: Contribution to journalArticle

Jawad, Muhammad U. ; Cheung, Michael C. ; Min, Elijah S. ; Schneiderbauer, Michaela M. ; Koniaris, Leonidas ; Scully, Sean P. / Ewing sarcoma demonstrates racial disparities in incidence-related and sex-related differences in outcome : An analysis of 1631 cases from the SEER database, 1973-2005. In: Cancer. 2009 ; Vol. 115, No. 15. pp. 3526-3536.
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abstract = "BACKGROUND: Previous reports of Ewing sarcoma cohorts suggested that there is a difference in incidence according to racial origin. However, to the authors' knowledge, this finding has never been tested in a population-based database, and the impact of race on clinical outcome and the significance of known risk factors stratified to racial groups have not been reported. METHODS: Patients who had Ewing sarcoma diagnosed between 1973 and 2005 were identified in the Surveillance, Epidemiology, and End Results database. Patient demographic and clinical characteristics; incidence; year of diagnosis; tumor location, tumor size, and disease stage at diagnosis; treatment(s); cause of death; and survival were extracted. Kaplan-Meier, log-rank, and Cox regressions were used to analyze the significance of prognostic factors. RESULTS: Race-specific incidence indicated that Caucasians have the highest incidence (0.155), followed by Asians/Pacific Islanders (0.082), and African Americans (0.017). The difference in incidence between Caucasians and African Americans was 9-fold and significant (P <.001). The incidence of Ewing sarcoma increased over the past 3 decades among Caucasians (P <.05). Survival was not impacted by race. Local disease stage, primary tumor location in the appendicular skeleton, and tumor size ≤8 cm conferred a significant survival benefit. Women demonstrated improved survival among the Caucasian patients (P <.03). CONCLUSIONS: To the authors' knowledge, this is the first report focusing on racial disparity in incidence of Ewing sarcoma. Caucasians were affected more frequently, although outcomes were similar between races. It is noteworthy that being a woman constituted a survival benefit only among the Caucasian patients. Further studies will need to clarify the reasons for racial disparities in incidence and for sex differences in survival.",
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T1 - Ewing sarcoma demonstrates racial disparities in incidence-related and sex-related differences in outcome

T2 - An analysis of 1631 cases from the SEER database, 1973-2005

AU - Jawad, Muhammad U.

AU - Cheung, Michael C.

AU - Min, Elijah S.

AU - Schneiderbauer, Michaela M.

AU - Koniaris, Leonidas

AU - Scully, Sean P.

PY - 2009/8/1

Y1 - 2009/8/1

N2 - BACKGROUND: Previous reports of Ewing sarcoma cohorts suggested that there is a difference in incidence according to racial origin. However, to the authors' knowledge, this finding has never been tested in a population-based database, and the impact of race on clinical outcome and the significance of known risk factors stratified to racial groups have not been reported. METHODS: Patients who had Ewing sarcoma diagnosed between 1973 and 2005 were identified in the Surveillance, Epidemiology, and End Results database. Patient demographic and clinical characteristics; incidence; year of diagnosis; tumor location, tumor size, and disease stage at diagnosis; treatment(s); cause of death; and survival were extracted. Kaplan-Meier, log-rank, and Cox regressions were used to analyze the significance of prognostic factors. RESULTS: Race-specific incidence indicated that Caucasians have the highest incidence (0.155), followed by Asians/Pacific Islanders (0.082), and African Americans (0.017). The difference in incidence between Caucasians and African Americans was 9-fold and significant (P <.001). The incidence of Ewing sarcoma increased over the past 3 decades among Caucasians (P <.05). Survival was not impacted by race. Local disease stage, primary tumor location in the appendicular skeleton, and tumor size ≤8 cm conferred a significant survival benefit. Women demonstrated improved survival among the Caucasian patients (P <.03). CONCLUSIONS: To the authors' knowledge, this is the first report focusing on racial disparity in incidence of Ewing sarcoma. Caucasians were affected more frequently, although outcomes were similar between races. It is noteworthy that being a woman constituted a survival benefit only among the Caucasian patients. Further studies will need to clarify the reasons for racial disparities in incidence and for sex differences in survival.

AB - BACKGROUND: Previous reports of Ewing sarcoma cohorts suggested that there is a difference in incidence according to racial origin. However, to the authors' knowledge, this finding has never been tested in a population-based database, and the impact of race on clinical outcome and the significance of known risk factors stratified to racial groups have not been reported. METHODS: Patients who had Ewing sarcoma diagnosed between 1973 and 2005 were identified in the Surveillance, Epidemiology, and End Results database. Patient demographic and clinical characteristics; incidence; year of diagnosis; tumor location, tumor size, and disease stage at diagnosis; treatment(s); cause of death; and survival were extracted. Kaplan-Meier, log-rank, and Cox regressions were used to analyze the significance of prognostic factors. RESULTS: Race-specific incidence indicated that Caucasians have the highest incidence (0.155), followed by Asians/Pacific Islanders (0.082), and African Americans (0.017). The difference in incidence between Caucasians and African Americans was 9-fold and significant (P <.001). The incidence of Ewing sarcoma increased over the past 3 decades among Caucasians (P <.05). Survival was not impacted by race. Local disease stage, primary tumor location in the appendicular skeleton, and tumor size ≤8 cm conferred a significant survival benefit. Women demonstrated improved survival among the Caucasian patients (P <.03). CONCLUSIONS: To the authors' knowledge, this is the first report focusing on racial disparity in incidence of Ewing sarcoma. Caucasians were affected more frequently, although outcomes were similar between races. It is noteworthy that being a woman constituted a survival benefit only among the Caucasian patients. Further studies will need to clarify the reasons for racial disparities in incidence and for sex differences in survival.

KW - Cancer registries

KW - End results program

KW - Epidemiology

KW - Incidence patterns

KW - Prognostic factors

KW - Racial origin

KW - Sex distribution

KW - Surveillance

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