Language
English
Publication Date
8-1-2025
Journal
Journal of Racial and Ethnic Health Disparities
DOI
10.1007/s40615-024-02077-y
PMID
38955957
PMCID
PMC11693772
PubMedCentral® Posted Date
7-10-2025
PubMedCentral® Full Text Version
Author MSS
Abstract
Background: It remains unclear what factors significantly drive racial disparity in cancer survival in the United States (US). We compared adjusted mortality outcomes in cancer patients from different racial and ethnic groups on a population level in the US and a single-payer healthcare system.
Patients and methods: We selected adult patients with incident solid and hematologic malignancies from the Surveillance, Epidemiology, and End Results (SEER) 2011-2020 and Veteran Affairs national healthcare system (VA) 2011-2021. We classified the self-reported NIH race and ethnicity into non-Hispanic White (NHW), non-Hispanic Black (NHB), non-Hispanic Asian Pacific Islander (API), and Hispanic. Cox regression models for hazard ratio of racial and ethnic groups were built after adjusting confounders in each cohort.
Results: The study included 3,104,657 patients from SEER and 287,619 patients from VA. There were notable differences in baseline characteristics in the two cohorts. In SEER, adjusted HR for mortality was 1.12 (95% CI, 1.12-1.13), 1.03 (95% CI, 1.03-1.04), and 0.91 (95% CI, 0.90-0.92), for NHB, Hispanic, and API patients, respectively, vs. NHW. In VA, adjusted HR was 0.94 (95% CI, 0.92-0.95), 0.84 (95% CI, 0.82-0.87), and 0.96 (95% CI, 0.93-1.00) for NHB, Hispanic, and API, respectively, vs. NHW. Additional subgroup analyses by cancer types, age, and sex did not significantly change these associations.
Conclusions: Racial disparity continues to persist on a population level in the US especially for NHB vs. NHW patients, where the adjusted mortality was 12% higher in the general population but 6% lower in the single-payer VA system.
Keywords
Humans, United States, Male, Female, Neoplasms, Middle Aged, Single-Payer System, Aged, SEER Program, Adult, Ethnicity, Racial Groups, Health Status Disparities, Health services accessibility, Healthcare disparities, Mortality, Neoplasms, Race factors
Published Open-Access
yes
Recommended Citation
Kim, Rock Bum; Zhou, Emily; Swinnerton, Kaitlin N; et al., "Racial and Ethnic Disparity for Cancer Mortality in General and Single-Payer Healthcare Systems in the United States" (2025). Faculty and Staff Publications. 4620.
https://digitalcommons.library.tmc.edu/baylor_docs/4620