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Recent Incidence and Survival Trends in Pancreatic Cancer at Young Age (<50 Years)

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Changed
Wed, 09/18/2024 - 15:43

Background

Pancreatic cancer stands as a prominent contributor to cancer-related mortality in the United States. In this abstract, we reviewed the SEER database to uncover the latest trends in pancreatic cancer among individuals diagnosed under the age of 50.

Methods

Information was obtained from the SEER database November 2023 which covers 22 national cancer registries. Only patients with age < 50 years were included. Age adjusted incidence and 5-year relative survival were compared between different ethnic groups.

Results

We identified 124691 patients with pancreatic cancer diagnosed between 2017-2021, among them 6477 were with age less than 50 years at the time of diagnosis. 3074 were male and 3403 were male. Age adjusted incidence rate was 1.2/100,000 in females and 1.4/100,000 in males. Overall, Average Annual Percent Change (AAPC) of 2.6% (95% CI: 1.9 – 4.3) was noticed between 2017-2021 when compared to previously reported rates. AAPC among different ethnic groups were Hispanics, any race: 5.3% (CI: 4-7.5), Non-Hispanic American Indian/Alaska Native: 1.1 (CI: -2.7-5.1), Non-Hispanic Asian/Pacific Islander: 1.9 (CI: 1.1-2.9), Non-Hispanic Black: 1.0 (CI: 0.3-1.7), and Non-Hispanic White: 1.6 (CI: 1.1-2.1). Stage 4 was the most common stage. Overall, the 5-year relative survival from 2014- 2020 was 37.4% (CI: 36.1-38.7). 5-year relative survival among ethnic groups from 2014-2020 were: Hispanics, any race: 40.3% (CI: 37.6-43.0), Non-Hispanic American Indian/Alaska Native: 21.4 (CI: 8.5-38.2), Non-Hispanic Asian/Pacific Islander: 40.2 (CI: 35.7-44.7), Non-Hispanic Black: 33.1 (CI: 29.9-36.3), and Non-Hispanic White: 36.6 (CI: 34.8-38.4).

Conclusions

Our analysis reveals a rise in the ageadjusted incidence of pancreatic cancer among younger demographics. Particularly noteworthy is the sharp increase observed over the past five years among Hispanics when compared to other ethnic populations. This rise is observed in both males and females. Further studies need to be done to study the risk factors associated with this increase in trend of pancreatic cancer at young age specifically in Hispanic population.

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Federal Practitioner - 41(9)s
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Page Number
S18
Sections

Background

Pancreatic cancer stands as a prominent contributor to cancer-related mortality in the United States. In this abstract, we reviewed the SEER database to uncover the latest trends in pancreatic cancer among individuals diagnosed under the age of 50.

Methods

Information was obtained from the SEER database November 2023 which covers 22 national cancer registries. Only patients with age < 50 years were included. Age adjusted incidence and 5-year relative survival were compared between different ethnic groups.

Results

We identified 124691 patients with pancreatic cancer diagnosed between 2017-2021, among them 6477 were with age less than 50 years at the time of diagnosis. 3074 were male and 3403 were male. Age adjusted incidence rate was 1.2/100,000 in females and 1.4/100,000 in males. Overall, Average Annual Percent Change (AAPC) of 2.6% (95% CI: 1.9 – 4.3) was noticed between 2017-2021 when compared to previously reported rates. AAPC among different ethnic groups were Hispanics, any race: 5.3% (CI: 4-7.5), Non-Hispanic American Indian/Alaska Native: 1.1 (CI: -2.7-5.1), Non-Hispanic Asian/Pacific Islander: 1.9 (CI: 1.1-2.9), Non-Hispanic Black: 1.0 (CI: 0.3-1.7), and Non-Hispanic White: 1.6 (CI: 1.1-2.1). Stage 4 was the most common stage. Overall, the 5-year relative survival from 2014- 2020 was 37.4% (CI: 36.1-38.7). 5-year relative survival among ethnic groups from 2014-2020 were: Hispanics, any race: 40.3% (CI: 37.6-43.0), Non-Hispanic American Indian/Alaska Native: 21.4 (CI: 8.5-38.2), Non-Hispanic Asian/Pacific Islander: 40.2 (CI: 35.7-44.7), Non-Hispanic Black: 33.1 (CI: 29.9-36.3), and Non-Hispanic White: 36.6 (CI: 34.8-38.4).

Conclusions

Our analysis reveals a rise in the ageadjusted incidence of pancreatic cancer among younger demographics. Particularly noteworthy is the sharp increase observed over the past five years among Hispanics when compared to other ethnic populations. This rise is observed in both males and females. Further studies need to be done to study the risk factors associated with this increase in trend of pancreatic cancer at young age specifically in Hispanic population.

Background

Pancreatic cancer stands as a prominent contributor to cancer-related mortality in the United States. In this abstract, we reviewed the SEER database to uncover the latest trends in pancreatic cancer among individuals diagnosed under the age of 50.

Methods

Information was obtained from the SEER database November 2023 which covers 22 national cancer registries. Only patients with age < 50 years were included. Age adjusted incidence and 5-year relative survival were compared between different ethnic groups.

Results

We identified 124691 patients with pancreatic cancer diagnosed between 2017-2021, among them 6477 were with age less than 50 years at the time of diagnosis. 3074 were male and 3403 were male. Age adjusted incidence rate was 1.2/100,000 in females and 1.4/100,000 in males. Overall, Average Annual Percent Change (AAPC) of 2.6% (95% CI: 1.9 – 4.3) was noticed between 2017-2021 when compared to previously reported rates. AAPC among different ethnic groups were Hispanics, any race: 5.3% (CI: 4-7.5), Non-Hispanic American Indian/Alaska Native: 1.1 (CI: -2.7-5.1), Non-Hispanic Asian/Pacific Islander: 1.9 (CI: 1.1-2.9), Non-Hispanic Black: 1.0 (CI: 0.3-1.7), and Non-Hispanic White: 1.6 (CI: 1.1-2.1). Stage 4 was the most common stage. Overall, the 5-year relative survival from 2014- 2020 was 37.4% (CI: 36.1-38.7). 5-year relative survival among ethnic groups from 2014-2020 were: Hispanics, any race: 40.3% (CI: 37.6-43.0), Non-Hispanic American Indian/Alaska Native: 21.4 (CI: 8.5-38.2), Non-Hispanic Asian/Pacific Islander: 40.2 (CI: 35.7-44.7), Non-Hispanic Black: 33.1 (CI: 29.9-36.3), and Non-Hispanic White: 36.6 (CI: 34.8-38.4).

Conclusions

Our analysis reveals a rise in the ageadjusted incidence of pancreatic cancer among younger demographics. Particularly noteworthy is the sharp increase observed over the past five years among Hispanics when compared to other ethnic populations. This rise is observed in both males and females. Further studies need to be done to study the risk factors associated with this increase in trend of pancreatic cancer at young age specifically in Hispanic population.

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Laterality in Renal Cancer: Effect on Survival in Veteran Population

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Wed, 09/18/2024 - 15:43

Background

Kidney and renal pelvis cancers (KC) represent 4% of new cancer cases in the US. Although it is a common cancer, there is no data to compare the effect of laterality on survival in veteran population. In this abstract, we attempt to bridge this gap and compare the effect of laterality on survival.

Methods

We obtained data from Albany VA (VAMC) for patients diagnosed with KC between 2010-2020. Data were analyzed for age, stage at diagnosis, histopathological type, laterality of tumor, and 6,12 and 60-months survival after the diagnosis and performed a comparison of overall survival of left versus rightsided cancer by calculating odds ratio using logistic regression, significance level was established at p< 0.05.

Results

We reviewed 130 patients diagnosed with KC at VAMC. 62 had right-sided, 62 had left-sided, and 6 had bilateral cancer. Clear cell (40.8%) was predominant type. Other less common histopathological types include Papillary RCC, mixed, papillary urothelial and transitional types. 58 patients had stage 1 (28 right versus 30 left), 8 had stage 2 (5 versus 3), 29 had stage 3 (13 versus 16), 16 with stage 4 (12 versus 4), and 14 had stage 0 (papillary-urothelial). 59.2% patients underwent surgical treatment after diagnosis (R=35, L=39). At 6-months, 60 patients (96.8%) with left-sided and 53 (85.5%) with right-sided cancer survived. The odds of surviving 6-months were 12% higher (95% CI: 1.014, 1.236; p=0.03) in left versus right-sided cancer. For 1-year survival, the results were similar. 111 patients completed a 5-year follow-up and there was no evidence to support a difference in survival between cohorts at 5-years: OR (95% CI: 0.88, 1.47; p=0.32).

Conclusions

In this study, we discovered that leftsided cancer showed better survival at 6-months and 1-year compared to right-sided cancer, but 5-year survival rates appeared similar irrespective of laterality of cancer. Both subgroups had similar distribution for baseline characteristics with majority of patients being males, older than 60 years, with stage 1 disease. Further studies in larger populations with wider distribution of baseline characteristics are needed to establish clear role of laterality as a prognostic factor.

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Federal Practitioner - 41(9)s
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Page Number
S17-S18
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Background

Kidney and renal pelvis cancers (KC) represent 4% of new cancer cases in the US. Although it is a common cancer, there is no data to compare the effect of laterality on survival in veteran population. In this abstract, we attempt to bridge this gap and compare the effect of laterality on survival.

Methods

We obtained data from Albany VA (VAMC) for patients diagnosed with KC between 2010-2020. Data were analyzed for age, stage at diagnosis, histopathological type, laterality of tumor, and 6,12 and 60-months survival after the diagnosis and performed a comparison of overall survival of left versus rightsided cancer by calculating odds ratio using logistic regression, significance level was established at p< 0.05.

Results

We reviewed 130 patients diagnosed with KC at VAMC. 62 had right-sided, 62 had left-sided, and 6 had bilateral cancer. Clear cell (40.8%) was predominant type. Other less common histopathological types include Papillary RCC, mixed, papillary urothelial and transitional types. 58 patients had stage 1 (28 right versus 30 left), 8 had stage 2 (5 versus 3), 29 had stage 3 (13 versus 16), 16 with stage 4 (12 versus 4), and 14 had stage 0 (papillary-urothelial). 59.2% patients underwent surgical treatment after diagnosis (R=35, L=39). At 6-months, 60 patients (96.8%) with left-sided and 53 (85.5%) with right-sided cancer survived. The odds of surviving 6-months were 12% higher (95% CI: 1.014, 1.236; p=0.03) in left versus right-sided cancer. For 1-year survival, the results were similar. 111 patients completed a 5-year follow-up and there was no evidence to support a difference in survival between cohorts at 5-years: OR (95% CI: 0.88, 1.47; p=0.32).

Conclusions

In this study, we discovered that leftsided cancer showed better survival at 6-months and 1-year compared to right-sided cancer, but 5-year survival rates appeared similar irrespective of laterality of cancer. Both subgroups had similar distribution for baseline characteristics with majority of patients being males, older than 60 years, with stage 1 disease. Further studies in larger populations with wider distribution of baseline characteristics are needed to establish clear role of laterality as a prognostic factor.

Background

Kidney and renal pelvis cancers (KC) represent 4% of new cancer cases in the US. Although it is a common cancer, there is no data to compare the effect of laterality on survival in veteran population. In this abstract, we attempt to bridge this gap and compare the effect of laterality on survival.

Methods

We obtained data from Albany VA (VAMC) for patients diagnosed with KC between 2010-2020. Data were analyzed for age, stage at diagnosis, histopathological type, laterality of tumor, and 6,12 and 60-months survival after the diagnosis and performed a comparison of overall survival of left versus rightsided cancer by calculating odds ratio using logistic regression, significance level was established at p< 0.05.

Results

We reviewed 130 patients diagnosed with KC at VAMC. 62 had right-sided, 62 had left-sided, and 6 had bilateral cancer. Clear cell (40.8%) was predominant type. Other less common histopathological types include Papillary RCC, mixed, papillary urothelial and transitional types. 58 patients had stage 1 (28 right versus 30 left), 8 had stage 2 (5 versus 3), 29 had stage 3 (13 versus 16), 16 with stage 4 (12 versus 4), and 14 had stage 0 (papillary-urothelial). 59.2% patients underwent surgical treatment after diagnosis (R=35, L=39). At 6-months, 60 patients (96.8%) with left-sided and 53 (85.5%) with right-sided cancer survived. The odds of surviving 6-months were 12% higher (95% CI: 1.014, 1.236; p=0.03) in left versus right-sided cancer. For 1-year survival, the results were similar. 111 patients completed a 5-year follow-up and there was no evidence to support a difference in survival between cohorts at 5-years: OR (95% CI: 0.88, 1.47; p=0.32).

Conclusions

In this study, we discovered that leftsided cancer showed better survival at 6-months and 1-year compared to right-sided cancer, but 5-year survival rates appeared similar irrespective of laterality of cancer. Both subgroups had similar distribution for baseline characteristics with majority of patients being males, older than 60 years, with stage 1 disease. Further studies in larger populations with wider distribution of baseline characteristics are needed to establish clear role of laterality as a prognostic factor.

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Federal Practitioner - 41(9)s
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S17-S18
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Surgical Management of SDH-Deficient Gastrointestinal Stromal Tumors (GIST): A National Cancer Database Review

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Changed
Wed, 09/18/2024 - 16:11

Background

To evaluate factors predicting surgical resection of SDH-deficient GIST and outcomes of adjuvant therapies. SDH-deficient GIST are very rare, comprising 5-7.5% of all GIST and most frequently occurring in the stomach or small bowel. Veterans who were exposed to burn pit toxins have an increased risk of developing these tumors. While most patients undergo surgery, there is limited information available regarding prognosis and survivability

Methods

The National Cancer Database was used to identify patients diagnosed with SDH-deficient GIST from 2004 to 2019 using histology code 8936 as assigned by the Commission on Cancer Accreditation program. Kaplan-Meier, ANOVA Chi-Square, and Logistic Regression tests were performed, and data were analyzed using SPSS version 29. Statistical significance was set at α = 0.05.

Results

721 patients with SDH-deficient GIST were queried, with 606 (84.05%) receiving surgical resection. Surgical patients experienced longer overall survival than non-surgical patients (116.3 months vs. 48.05 months, p< 0.001), with 248 (40.9%) patients undergoing a lobectomy and 29 (4.79%) patients undergoing a wedge/segmental resection. Patients who received wedge/segmental resection survived for 109.5 months while those who received a lobectomy survived for 108.6 months. Both surgeries showed a greater survival than other types of resections (p< 0.001). Of the initial sample, 42 (6.93%) patients received adjuvant chemotherapy, 3 (0.50%) patients received adjuvant radiation, and 3 (0.50%) patients received both. None of these adjuvants impacted overall survival. Stage I-II disease and well to moderately differentiated disease predicted an increased likelihood of receiving surgery (p< 0.001), while liver metastases predicted a decreased likelihood of receiving surgery (p< 0.001). Income status, race, insurance, facility type, and age were not significant predicting factors of receiving surgery.

Conclusions

Surgical resection of SDH-deficient GIST is associated with improved overall survival. Adjuvant therapies do not significantly improve survival over surgery alone. Patients with lower stage and grade of disease are more likely to receive surgery, while other social, economic, and demographic factors do not significantly affect the likelihood of receiving surgery. Surgical resection of SDH-deficient GIST is significantly associated with improved overall survival without the need for adjuvant therapies.

Issue
Federal Practitioner - 41(9)s
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Page Number
S17
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Background

To evaluate factors predicting surgical resection of SDH-deficient GIST and outcomes of adjuvant therapies. SDH-deficient GIST are very rare, comprising 5-7.5% of all GIST and most frequently occurring in the stomach or small bowel. Veterans who were exposed to burn pit toxins have an increased risk of developing these tumors. While most patients undergo surgery, there is limited information available regarding prognosis and survivability

Methods

The National Cancer Database was used to identify patients diagnosed with SDH-deficient GIST from 2004 to 2019 using histology code 8936 as assigned by the Commission on Cancer Accreditation program. Kaplan-Meier, ANOVA Chi-Square, and Logistic Regression tests were performed, and data were analyzed using SPSS version 29. Statistical significance was set at α = 0.05.

Results

721 patients with SDH-deficient GIST were queried, with 606 (84.05%) receiving surgical resection. Surgical patients experienced longer overall survival than non-surgical patients (116.3 months vs. 48.05 months, p< 0.001), with 248 (40.9%) patients undergoing a lobectomy and 29 (4.79%) patients undergoing a wedge/segmental resection. Patients who received wedge/segmental resection survived for 109.5 months while those who received a lobectomy survived for 108.6 months. Both surgeries showed a greater survival than other types of resections (p< 0.001). Of the initial sample, 42 (6.93%) patients received adjuvant chemotherapy, 3 (0.50%) patients received adjuvant radiation, and 3 (0.50%) patients received both. None of these adjuvants impacted overall survival. Stage I-II disease and well to moderately differentiated disease predicted an increased likelihood of receiving surgery (p< 0.001), while liver metastases predicted a decreased likelihood of receiving surgery (p< 0.001). Income status, race, insurance, facility type, and age were not significant predicting factors of receiving surgery.

Conclusions

Surgical resection of SDH-deficient GIST is associated with improved overall survival. Adjuvant therapies do not significantly improve survival over surgery alone. Patients with lower stage and grade of disease are more likely to receive surgery, while other social, economic, and demographic factors do not significantly affect the likelihood of receiving surgery. Surgical resection of SDH-deficient GIST is significantly associated with improved overall survival without the need for adjuvant therapies.

Background

To evaluate factors predicting surgical resection of SDH-deficient GIST and outcomes of adjuvant therapies. SDH-deficient GIST are very rare, comprising 5-7.5% of all GIST and most frequently occurring in the stomach or small bowel. Veterans who were exposed to burn pit toxins have an increased risk of developing these tumors. While most patients undergo surgery, there is limited information available regarding prognosis and survivability

Methods

The National Cancer Database was used to identify patients diagnosed with SDH-deficient GIST from 2004 to 2019 using histology code 8936 as assigned by the Commission on Cancer Accreditation program. Kaplan-Meier, ANOVA Chi-Square, and Logistic Regression tests were performed, and data were analyzed using SPSS version 29. Statistical significance was set at α = 0.05.

Results

721 patients with SDH-deficient GIST were queried, with 606 (84.05%) receiving surgical resection. Surgical patients experienced longer overall survival than non-surgical patients (116.3 months vs. 48.05 months, p< 0.001), with 248 (40.9%) patients undergoing a lobectomy and 29 (4.79%) patients undergoing a wedge/segmental resection. Patients who received wedge/segmental resection survived for 109.5 months while those who received a lobectomy survived for 108.6 months. Both surgeries showed a greater survival than other types of resections (p< 0.001). Of the initial sample, 42 (6.93%) patients received adjuvant chemotherapy, 3 (0.50%) patients received adjuvant radiation, and 3 (0.50%) patients received both. None of these adjuvants impacted overall survival. Stage I-II disease and well to moderately differentiated disease predicted an increased likelihood of receiving surgery (p< 0.001), while liver metastases predicted a decreased likelihood of receiving surgery (p< 0.001). Income status, race, insurance, facility type, and age were not significant predicting factors of receiving surgery.

Conclusions

Surgical resection of SDH-deficient GIST is associated with improved overall survival. Adjuvant therapies do not significantly improve survival over surgery alone. Patients with lower stage and grade of disease are more likely to receive surgery, while other social, economic, and demographic factors do not significantly affect the likelihood of receiving surgery. Surgical resection of SDH-deficient GIST is significantly associated with improved overall survival without the need for adjuvant therapies.

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Factors Affecting Academic Center Access in Merkel Cell Carcinoma: An NCDB Analysis

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Changed
Wed, 09/18/2024 - 16:11

Background

To identify socio-demographic factors affecting academic center access in Merkel cell carcinoma (MCC) patients. MCC is a leading cause of skin cancer death, disproportionately affecting males over 65. Treatment at academic cancer centers has been shown to improve survival in MCC, but there is limited literature on factors affecting accessibility. The National Cancer Database (NCDB) was analyzed to determine variables impacting treatment at academic versus non-academic facility types in MCC.

Methods

A retrospective cohort analysis using the NCDB from 2004 to 2021 included 21,866 patients with histologically confirmed MCC. Socio-demographic factors collected include sex, age, race, Hispanic status, population density, education level, income level, and distance to the treatment facility. Multivariate analysis of factors on academic center facility type was performed via binary logistic regression. Kaplan-Meier curves were used to estimate overall survival. A significance level of 0.05 was used.

Results

The majority of MCC patients were male (63.9%) and treated at a non-academic center (56.7%) with an average age of 74.4 (SD=10.8). Overall survival was significantly better at academic versus non-academic centers (97.1 months vs 80.1 months, P< 0.05). Those who were treated at a non-academic center were older (OR=1.004; CI, 1.001-1.007). Native Americans were 2.06 times as likely to be treated at a non-academic center relative to White patients (95% CI, 1.00-4.24). Patients with median household incomes in the top first or second quartile were 0.62 and 0.86 times as likely to receive treatment at a non-academic center compared to those in the bottom quartile (95% CI, 0.55-0.69 and CI, 0.77- 0.95, respectively). Those who were treated at an academic center lived in an urban area but traveled further for care (P< 0.05; 64.9 miles vs 20.7 miles, respectively).

Conclusions

Treatment at academic centers significantly improves survival in MCC patients. The results show that Native American, low-income, and older patients are undertreated at academic facilities, highlighting inequalities in access to care. Addressing these disparities is crucial for improving overall outcomes in MCC.

Issue
Federal Practitioner - 41(9)s
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S17
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Background

To identify socio-demographic factors affecting academic center access in Merkel cell carcinoma (MCC) patients. MCC is a leading cause of skin cancer death, disproportionately affecting males over 65. Treatment at academic cancer centers has been shown to improve survival in MCC, but there is limited literature on factors affecting accessibility. The National Cancer Database (NCDB) was analyzed to determine variables impacting treatment at academic versus non-academic facility types in MCC.

Methods

A retrospective cohort analysis using the NCDB from 2004 to 2021 included 21,866 patients with histologically confirmed MCC. Socio-demographic factors collected include sex, age, race, Hispanic status, population density, education level, income level, and distance to the treatment facility. Multivariate analysis of factors on academic center facility type was performed via binary logistic regression. Kaplan-Meier curves were used to estimate overall survival. A significance level of 0.05 was used.

Results

The majority of MCC patients were male (63.9%) and treated at a non-academic center (56.7%) with an average age of 74.4 (SD=10.8). Overall survival was significantly better at academic versus non-academic centers (97.1 months vs 80.1 months, P< 0.05). Those who were treated at a non-academic center were older (OR=1.004; CI, 1.001-1.007). Native Americans were 2.06 times as likely to be treated at a non-academic center relative to White patients (95% CI, 1.00-4.24). Patients with median household incomes in the top first or second quartile were 0.62 and 0.86 times as likely to receive treatment at a non-academic center compared to those in the bottom quartile (95% CI, 0.55-0.69 and CI, 0.77- 0.95, respectively). Those who were treated at an academic center lived in an urban area but traveled further for care (P< 0.05; 64.9 miles vs 20.7 miles, respectively).

Conclusions

Treatment at academic centers significantly improves survival in MCC patients. The results show that Native American, low-income, and older patients are undertreated at academic facilities, highlighting inequalities in access to care. Addressing these disparities is crucial for improving overall outcomes in MCC.

Background

To identify socio-demographic factors affecting academic center access in Merkel cell carcinoma (MCC) patients. MCC is a leading cause of skin cancer death, disproportionately affecting males over 65. Treatment at academic cancer centers has been shown to improve survival in MCC, but there is limited literature on factors affecting accessibility. The National Cancer Database (NCDB) was analyzed to determine variables impacting treatment at academic versus non-academic facility types in MCC.

Methods

A retrospective cohort analysis using the NCDB from 2004 to 2021 included 21,866 patients with histologically confirmed MCC. Socio-demographic factors collected include sex, age, race, Hispanic status, population density, education level, income level, and distance to the treatment facility. Multivariate analysis of factors on academic center facility type was performed via binary logistic regression. Kaplan-Meier curves were used to estimate overall survival. A significance level of 0.05 was used.

Results

The majority of MCC patients were male (63.9%) and treated at a non-academic center (56.7%) with an average age of 74.4 (SD=10.8). Overall survival was significantly better at academic versus non-academic centers (97.1 months vs 80.1 months, P< 0.05). Those who were treated at a non-academic center were older (OR=1.004; CI, 1.001-1.007). Native Americans were 2.06 times as likely to be treated at a non-academic center relative to White patients (95% CI, 1.00-4.24). Patients with median household incomes in the top first or second quartile were 0.62 and 0.86 times as likely to receive treatment at a non-academic center compared to those in the bottom quartile (95% CI, 0.55-0.69 and CI, 0.77- 0.95, respectively). Those who were treated at an academic center lived in an urban area but traveled further for care (P< 0.05; 64.9 miles vs 20.7 miles, respectively).

Conclusions

Treatment at academic centers significantly improves survival in MCC patients. The results show that Native American, low-income, and older patients are undertreated at academic facilities, highlighting inequalities in access to care. Addressing these disparities is crucial for improving overall outcomes in MCC.

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S17
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Impact of Facility Type on Survival Outcomes in Pancreatic Neuroendocrine Carcinoma: An Analysis of the National Cancer Database

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Changed
Wed, 09/18/2024 - 16:10

Background

This study aims to evaluate the impact of treatment facility type on the long-term survival rates of patients with pancreatic neuroendocrine tumors, as well as the demographic and treatment differences between these groups. Pancreatic neuroendocrine tumors are a rare form of pancreatic cancer with a highly variable survival rate. While existing cancer research indicates that patients treated at academic facilities generally experience improved survival outcomes compared to low income patients, there is little research on this topic in the context of pancreatic neuroendocrine tumors.

Methods

The National Cancer Database (NCDB) was used to identify patients diagnosed with pancreatic neuroendocrine carcinoma from 2004 to 2019 using the histology code 8246 as assigned by the Commission on Cancer Accreditation program. Kaplan-Meier, ANOVA, and Chi-Square tests were performed. Data was analyzed using SPSS version 27 and statistical significance was set at α = 0.05.

Results

In this analysis of 13,987 patients, 6,957 (49.7%) were treated at academic facilities, while 7,012 (50.3%) were treated at non-academic facilities. Patients treated at academic facilities experienced a significantly increased mean survival rate of 100.5 months following diagnosis compared to the 75.6 month mean survival rate of patients treated at non-academic facilities (p< 0.05). Additionally, patients treated at academic facilities were more likely to be black, have private insurance, undergo surgery, and live in a metropolitan area with a population larger than 1 million (p< 0.05). Conversely, patients treated at non-academic facilities experienced a worse 30-day and 90-day mortality, had a higher average Charlson-Deyo Comorbidity Index, and lived closer to their treatment facility (p< 0.05). Patients’ income did not differ significantly.

Conclusions

This study showed that patients with pancreatic neuroendocrine carcinomas treated at academic facilities experienced a significantly improved overall survival rate compared to low income patients. This disparity may be attributed to differences in rates of surgical intervention or insurance status, among other factors. These observations are based on correlational data, and they underscore the necessity for further investigation to establish causality.

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Background

This study aims to evaluate the impact of treatment facility type on the long-term survival rates of patients with pancreatic neuroendocrine tumors, as well as the demographic and treatment differences between these groups. Pancreatic neuroendocrine tumors are a rare form of pancreatic cancer with a highly variable survival rate. While existing cancer research indicates that patients treated at academic facilities generally experience improved survival outcomes compared to low income patients, there is little research on this topic in the context of pancreatic neuroendocrine tumors.

Methods

The National Cancer Database (NCDB) was used to identify patients diagnosed with pancreatic neuroendocrine carcinoma from 2004 to 2019 using the histology code 8246 as assigned by the Commission on Cancer Accreditation program. Kaplan-Meier, ANOVA, and Chi-Square tests were performed. Data was analyzed using SPSS version 27 and statistical significance was set at α = 0.05.

Results

In this analysis of 13,987 patients, 6,957 (49.7%) were treated at academic facilities, while 7,012 (50.3%) were treated at non-academic facilities. Patients treated at academic facilities experienced a significantly increased mean survival rate of 100.5 months following diagnosis compared to the 75.6 month mean survival rate of patients treated at non-academic facilities (p< 0.05). Additionally, patients treated at academic facilities were more likely to be black, have private insurance, undergo surgery, and live in a metropolitan area with a population larger than 1 million (p< 0.05). Conversely, patients treated at non-academic facilities experienced a worse 30-day and 90-day mortality, had a higher average Charlson-Deyo Comorbidity Index, and lived closer to their treatment facility (p< 0.05). Patients’ income did not differ significantly.

Conclusions

This study showed that patients with pancreatic neuroendocrine carcinomas treated at academic facilities experienced a significantly improved overall survival rate compared to low income patients. This disparity may be attributed to differences in rates of surgical intervention or insurance status, among other factors. These observations are based on correlational data, and they underscore the necessity for further investigation to establish causality.

Background

This study aims to evaluate the impact of treatment facility type on the long-term survival rates of patients with pancreatic neuroendocrine tumors, as well as the demographic and treatment differences between these groups. Pancreatic neuroendocrine tumors are a rare form of pancreatic cancer with a highly variable survival rate. While existing cancer research indicates that patients treated at academic facilities generally experience improved survival outcomes compared to low income patients, there is little research on this topic in the context of pancreatic neuroendocrine tumors.

Methods

The National Cancer Database (NCDB) was used to identify patients diagnosed with pancreatic neuroendocrine carcinoma from 2004 to 2019 using the histology code 8246 as assigned by the Commission on Cancer Accreditation program. Kaplan-Meier, ANOVA, and Chi-Square tests were performed. Data was analyzed using SPSS version 27 and statistical significance was set at α = 0.05.

Results

In this analysis of 13,987 patients, 6,957 (49.7%) were treated at academic facilities, while 7,012 (50.3%) were treated at non-academic facilities. Patients treated at academic facilities experienced a significantly increased mean survival rate of 100.5 months following diagnosis compared to the 75.6 month mean survival rate of patients treated at non-academic facilities (p< 0.05). Additionally, patients treated at academic facilities were more likely to be black, have private insurance, undergo surgery, and live in a metropolitan area with a population larger than 1 million (p< 0.05). Conversely, patients treated at non-academic facilities experienced a worse 30-day and 90-day mortality, had a higher average Charlson-Deyo Comorbidity Index, and lived closer to their treatment facility (p< 0.05). Patients’ income did not differ significantly.

Conclusions

This study showed that patients with pancreatic neuroendocrine carcinomas treated at academic facilities experienced a significantly improved overall survival rate compared to low income patients. This disparity may be attributed to differences in rates of surgical intervention or insurance status, among other factors. These observations are based on correlational data, and they underscore the necessity for further investigation to establish causality.

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An NCDB Analysis of Factors Associated With the Receipt of Surgery in Myxoid/Round Cell Liposarcoma

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Background

Myxoid/round cell liposarcoma (MRCLS) is a rare soft tissue sarcoma originating from adipocytes and most commonly occurs in patients aged 20 to 40. Though slow-growing, MRCLS has a high propensity to metastasize. Complete surgical resection is central in the treatment of MRCLS. However, no significant study has analyzed the factors that predict the utilization of surgical therapy in MRCLS patients. This study also aims to characterize the effect of different treatment modalities on overall survival of these patients.

Methods

The National Cancer Database (NCDB) was used to identify patients diagnosed with MRCLS from 2004 to 2019 using the histology code 8852 as assigned by the Commission on Cancer Accreditation program. Kaplan-Meier, ANOVA Chi-Square, and Multilevel Logistic Regression were performed, and data were analyzed using SPSS version 29. Statistical significance was set at α = 0.05.

Results

5365 patients with MRCLS were queried. 4811 (89.8%) patients received surgery. Surgical patients experienced greater overall survival compared to nonsurgical patients (159.17 vs 93.72 months, p < 0.001). Wedge/segmental resection (1551 patients, 32.2%) and lobectomy resection (2724 patients, 56.6%) were associated with improved survival over other surgery types (OS =161.0 months, p < 0.001). Private insurance status and care at an academic facility were associated with an increased likelihood of receiving surgery (p< 0.001). Metastasis was associated with a decreased likelihood of receiving surgery (p< 0.001). On nominal regression, grades I-II, stages 1-3, and histologically well to moderately differentiated disease were associated with a greater likelihood of receiving surgery. Adjuvant therapy did not appear to impact survival.

Conclusions

This study reaffirms that tumor resection is associated with increased overall survival in MRCLS patients. Specifically, wedge/segmental and lobectomy surgery types are associated with improved outcomes. It appears that care at an academic facility, private insurance status, lower stage and grade of disease, and well-differentiated histology are correlated to an increased likelihood of receiving surgical treatment. Metastasis is associated with a decreased chance of receiving surgery. This research serves as the start to a better understanding of the factors involved in the receipt of tumor resection, as it is the mainstay of MRCLS treatment.

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Background

Myxoid/round cell liposarcoma (MRCLS) is a rare soft tissue sarcoma originating from adipocytes and most commonly occurs in patients aged 20 to 40. Though slow-growing, MRCLS has a high propensity to metastasize. Complete surgical resection is central in the treatment of MRCLS. However, no significant study has analyzed the factors that predict the utilization of surgical therapy in MRCLS patients. This study also aims to characterize the effect of different treatment modalities on overall survival of these patients.

Methods

The National Cancer Database (NCDB) was used to identify patients diagnosed with MRCLS from 2004 to 2019 using the histology code 8852 as assigned by the Commission on Cancer Accreditation program. Kaplan-Meier, ANOVA Chi-Square, and Multilevel Logistic Regression were performed, and data were analyzed using SPSS version 29. Statistical significance was set at α = 0.05.

Results

5365 patients with MRCLS were queried. 4811 (89.8%) patients received surgery. Surgical patients experienced greater overall survival compared to nonsurgical patients (159.17 vs 93.72 months, p < 0.001). Wedge/segmental resection (1551 patients, 32.2%) and lobectomy resection (2724 patients, 56.6%) were associated with improved survival over other surgery types (OS =161.0 months, p < 0.001). Private insurance status and care at an academic facility were associated with an increased likelihood of receiving surgery (p< 0.001). Metastasis was associated with a decreased likelihood of receiving surgery (p< 0.001). On nominal regression, grades I-II, stages 1-3, and histologically well to moderately differentiated disease were associated with a greater likelihood of receiving surgery. Adjuvant therapy did not appear to impact survival.

Conclusions

This study reaffirms that tumor resection is associated with increased overall survival in MRCLS patients. Specifically, wedge/segmental and lobectomy surgery types are associated with improved outcomes. It appears that care at an academic facility, private insurance status, lower stage and grade of disease, and well-differentiated histology are correlated to an increased likelihood of receiving surgical treatment. Metastasis is associated with a decreased chance of receiving surgery. This research serves as the start to a better understanding of the factors involved in the receipt of tumor resection, as it is the mainstay of MRCLS treatment.

Background

Myxoid/round cell liposarcoma (MRCLS) is a rare soft tissue sarcoma originating from adipocytes and most commonly occurs in patients aged 20 to 40. Though slow-growing, MRCLS has a high propensity to metastasize. Complete surgical resection is central in the treatment of MRCLS. However, no significant study has analyzed the factors that predict the utilization of surgical therapy in MRCLS patients. This study also aims to characterize the effect of different treatment modalities on overall survival of these patients.

Methods

The National Cancer Database (NCDB) was used to identify patients diagnosed with MRCLS from 2004 to 2019 using the histology code 8852 as assigned by the Commission on Cancer Accreditation program. Kaplan-Meier, ANOVA Chi-Square, and Multilevel Logistic Regression were performed, and data were analyzed using SPSS version 29. Statistical significance was set at α = 0.05.

Results

5365 patients with MRCLS were queried. 4811 (89.8%) patients received surgery. Surgical patients experienced greater overall survival compared to nonsurgical patients (159.17 vs 93.72 months, p < 0.001). Wedge/segmental resection (1551 patients, 32.2%) and lobectomy resection (2724 patients, 56.6%) were associated with improved survival over other surgery types (OS =161.0 months, p < 0.001). Private insurance status and care at an academic facility were associated with an increased likelihood of receiving surgery (p< 0.001). Metastasis was associated with a decreased likelihood of receiving surgery (p< 0.001). On nominal regression, grades I-II, stages 1-3, and histologically well to moderately differentiated disease were associated with a greater likelihood of receiving surgery. Adjuvant therapy did not appear to impact survival.

Conclusions

This study reaffirms that tumor resection is associated with increased overall survival in MRCLS patients. Specifically, wedge/segmental and lobectomy surgery types are associated with improved outcomes. It appears that care at an academic facility, private insurance status, lower stage and grade of disease, and well-differentiated histology are correlated to an increased likelihood of receiving surgical treatment. Metastasis is associated with a decreased chance of receiving surgery. This research serves as the start to a better understanding of the factors involved in the receipt of tumor resection, as it is the mainstay of MRCLS treatment.

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Clear Cell Sarcoma Incidence and Survival: A SEER Database Analysis

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Background

Clear cell sarcoma (CCS) is a rare soft tissue cancer that predominantly affects young to middle-aged adults. Current literature lacks recent accurate estimates of patient outcomes due to the disease’s low incidence and the small sample sizes in studies, particularly at a national registry level. This study aims to examine the incidence and survival of patients with CCS.

Methods

Patients from the Surveillance, Epidemiology, and End Results (SEER) database diagnosed with CCS between 2000-2020 were selected. Additional variables were collected including age, sex, race, stage, presence of metastases, tumor size, treatment status for surgery, radiation, and chemotherapy, time to treatment, median household income, and population size. Descriptive statistics, population-based incidence, log-rank tests with Kaplan-Meier curves, and Cox regression analyses were performed.

Results

A total of 287 patients were included. The population-adjusted incidence ranged from 0.012/100000 in 2004 to 0.027/100000 in 2010. The total percent change over the study period was 16.751% and the annual percent change, which did not change significantly over the study period, was 0.561%. The survival rate was 78.4% at one year, 62.0% at three years, and 57.1% at five years. Log-rank results showed Black patients survived shorter than White and Hispanic patients. Further, greater staging and tumor size >4.0cm were associated with shorter survival (p’s< 0.001). After controlling for covariates, Cox regression results showed Black patients were associated with shorter survival compared to White patients (p=0.038, hazard ratio=2.590). No other covariates were significantly associated with survival.

Conclusions

The findings showed CCS incidence is unchanged in recent years and prognosis is poor. Additionally, Black patients were associated with shorter survival duration compared to White patients. Contrary to prior findings on CCS, staging and tumor size were only significantly associated during univariate analyses, but not on Cox regression. The study was limited by a small sample size and variables found in the SEER database. Nonetheless, future research will benefit from assessing how race is an independent risk factor for CCS survival and how the prognosis of CCS patients can be improved.

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Background

Clear cell sarcoma (CCS) is a rare soft tissue cancer that predominantly affects young to middle-aged adults. Current literature lacks recent accurate estimates of patient outcomes due to the disease’s low incidence and the small sample sizes in studies, particularly at a national registry level. This study aims to examine the incidence and survival of patients with CCS.

Methods

Patients from the Surveillance, Epidemiology, and End Results (SEER) database diagnosed with CCS between 2000-2020 were selected. Additional variables were collected including age, sex, race, stage, presence of metastases, tumor size, treatment status for surgery, radiation, and chemotherapy, time to treatment, median household income, and population size. Descriptive statistics, population-based incidence, log-rank tests with Kaplan-Meier curves, and Cox regression analyses were performed.

Results

A total of 287 patients were included. The population-adjusted incidence ranged from 0.012/100000 in 2004 to 0.027/100000 in 2010. The total percent change over the study period was 16.751% and the annual percent change, which did not change significantly over the study period, was 0.561%. The survival rate was 78.4% at one year, 62.0% at three years, and 57.1% at five years. Log-rank results showed Black patients survived shorter than White and Hispanic patients. Further, greater staging and tumor size >4.0cm were associated with shorter survival (p’s< 0.001). After controlling for covariates, Cox regression results showed Black patients were associated with shorter survival compared to White patients (p=0.038, hazard ratio=2.590). No other covariates were significantly associated with survival.

Conclusions

The findings showed CCS incidence is unchanged in recent years and prognosis is poor. Additionally, Black patients were associated with shorter survival duration compared to White patients. Contrary to prior findings on CCS, staging and tumor size were only significantly associated during univariate analyses, but not on Cox regression. The study was limited by a small sample size and variables found in the SEER database. Nonetheless, future research will benefit from assessing how race is an independent risk factor for CCS survival and how the prognosis of CCS patients can be improved.

Background

Clear cell sarcoma (CCS) is a rare soft tissue cancer that predominantly affects young to middle-aged adults. Current literature lacks recent accurate estimates of patient outcomes due to the disease’s low incidence and the small sample sizes in studies, particularly at a national registry level. This study aims to examine the incidence and survival of patients with CCS.

Methods

Patients from the Surveillance, Epidemiology, and End Results (SEER) database diagnosed with CCS between 2000-2020 were selected. Additional variables were collected including age, sex, race, stage, presence of metastases, tumor size, treatment status for surgery, radiation, and chemotherapy, time to treatment, median household income, and population size. Descriptive statistics, population-based incidence, log-rank tests with Kaplan-Meier curves, and Cox regression analyses were performed.

Results

A total of 287 patients were included. The population-adjusted incidence ranged from 0.012/100000 in 2004 to 0.027/100000 in 2010. The total percent change over the study period was 16.751% and the annual percent change, which did not change significantly over the study period, was 0.561%. The survival rate was 78.4% at one year, 62.0% at three years, and 57.1% at five years. Log-rank results showed Black patients survived shorter than White and Hispanic patients. Further, greater staging and tumor size >4.0cm were associated with shorter survival (p’s< 0.001). After controlling for covariates, Cox regression results showed Black patients were associated with shorter survival compared to White patients (p=0.038, hazard ratio=2.590). No other covariates were significantly associated with survival.

Conclusions

The findings showed CCS incidence is unchanged in recent years and prognosis is poor. Additionally, Black patients were associated with shorter survival duration compared to White patients. Contrary to prior findings on CCS, staging and tumor size were only significantly associated during univariate analyses, but not on Cox regression. The study was limited by a small sample size and variables found in the SEER database. Nonetheless, future research will benefit from assessing how race is an independent risk factor for CCS survival and how the prognosis of CCS patients can be improved.

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Survival and Incidence of Gastric Neuroendocrine Tumors: A SEER Database Analysis

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Background

Gastric neuroendocrine tumors (GNETs) are slow-growing tumors derived from enterochromaffinlike cells whose prognosis depends on the type. Prior GNET studies have shown an increasing incidence but survival analyses have been more limited. This study aims to investigate if the increasing incidence trend continues and better describe factors associated with survival for GNET patients.

Methods

Patients diagnosed with GNET between 2000-2020 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Additional variables collected were age, sex, race, stage, presence of metastases, tumor size, treatment status for surgery, radiation, and chemotherapy, median household income, and population size. Descriptive statistics, population-based incidence, log-rank tests with Kaplan-Meier curves, and Cox regression analyses were performed.

Results

A total of 6512 patients were included. The one-, three-, and five-year survival rates were 90.4%, 85.0%, and 83.8%, respectively. The population-adjusted incidence ranged from 0.272/100000 in 2000 to 0.680/100000 in 2018. The total percent change in incidence over the study range was 104.1% with an annual percent change of 4.27%, which met significance <2.0cm and >5.0cm were associated with shorter survival (p’s< 0.05). Additionally, females, Hispanic patients, and recipients of surgery were associated with longer survival (p’s< 0.05).

Conclusions

The findings show GNET incidence has continued to increase over the past two decades. Additionally, clinical factors including stage, extent of metastasis, tumor size and socioeconomic factors like age, gender, and race were associated with changes in GNET survival. In the context of increasing incidence of GNET these findings describe factors associated with lower- and higher-risk tumors. Further assessment of these risk factors can benefit future research to better understand why GNET incidence is increasing, aid in risk stratification of GNET patients, and improve the prognosis of GNET.

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Background

Gastric neuroendocrine tumors (GNETs) are slow-growing tumors derived from enterochromaffinlike cells whose prognosis depends on the type. Prior GNET studies have shown an increasing incidence but survival analyses have been more limited. This study aims to investigate if the increasing incidence trend continues and better describe factors associated with survival for GNET patients.

Methods

Patients diagnosed with GNET between 2000-2020 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Additional variables collected were age, sex, race, stage, presence of metastases, tumor size, treatment status for surgery, radiation, and chemotherapy, median household income, and population size. Descriptive statistics, population-based incidence, log-rank tests with Kaplan-Meier curves, and Cox regression analyses were performed.

Results

A total of 6512 patients were included. The one-, three-, and five-year survival rates were 90.4%, 85.0%, and 83.8%, respectively. The population-adjusted incidence ranged from 0.272/100000 in 2000 to 0.680/100000 in 2018. The total percent change in incidence over the study range was 104.1% with an annual percent change of 4.27%, which met significance <2.0cm and >5.0cm were associated with shorter survival (p’s< 0.05). Additionally, females, Hispanic patients, and recipients of surgery were associated with longer survival (p’s< 0.05).

Conclusions

The findings show GNET incidence has continued to increase over the past two decades. Additionally, clinical factors including stage, extent of metastasis, tumor size and socioeconomic factors like age, gender, and race were associated with changes in GNET survival. In the context of increasing incidence of GNET these findings describe factors associated with lower- and higher-risk tumors. Further assessment of these risk factors can benefit future research to better understand why GNET incidence is increasing, aid in risk stratification of GNET patients, and improve the prognosis of GNET.

Background

Gastric neuroendocrine tumors (GNETs) are slow-growing tumors derived from enterochromaffinlike cells whose prognosis depends on the type. Prior GNET studies have shown an increasing incidence but survival analyses have been more limited. This study aims to investigate if the increasing incidence trend continues and better describe factors associated with survival for GNET patients.

Methods

Patients diagnosed with GNET between 2000-2020 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Additional variables collected were age, sex, race, stage, presence of metastases, tumor size, treatment status for surgery, radiation, and chemotherapy, median household income, and population size. Descriptive statistics, population-based incidence, log-rank tests with Kaplan-Meier curves, and Cox regression analyses were performed.

Results

A total of 6512 patients were included. The one-, three-, and five-year survival rates were 90.4%, 85.0%, and 83.8%, respectively. The population-adjusted incidence ranged from 0.272/100000 in 2000 to 0.680/100000 in 2018. The total percent change in incidence over the study range was 104.1% with an annual percent change of 4.27%, which met significance <2.0cm and >5.0cm were associated with shorter survival (p’s< 0.05). Additionally, females, Hispanic patients, and recipients of surgery were associated with longer survival (p’s< 0.05).

Conclusions

The findings show GNET incidence has continued to increase over the past two decades. Additionally, clinical factors including stage, extent of metastasis, tumor size and socioeconomic factors like age, gender, and race were associated with changes in GNET survival. In the context of increasing incidence of GNET these findings describe factors associated with lower- and higher-risk tumors. Further assessment of these risk factors can benefit future research to better understand why GNET incidence is increasing, aid in risk stratification of GNET patients, and improve the prognosis of GNET.

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Changes in Age-Related Mortality in Malignant Melanoma From 1999- 2022: A CDC Wonder Study

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Background

Melanoma is one of the leading causes of solid tumor cancers. This study’s objective is to analyze temporal trends in melanoma-related mortality among age groups in the US before and during COVID-19. To date, no previous studies have analyzed year-to-year trends in melanoma mortality by age group using the CDC Wonder database. A 2011 analysis previously showed increasing death rates only among those over age 65 between 1992-2006.

Methods

The CDC Wonder database was used to collect data on melanoma-related mortality rates in the US from 1999-2022. Crude mortality rates per 100,000 and annual percentage change using Joinpoint regression were used to analyze yearly trends among age groups.

Results

From 1999 to 2022, overall mortality rate fell from 2.91 to 2.07, and mortality rates among all age groups decreased with the exception of those over age 85. Age 35-44 crude mortality rate decreased from 1.42 to .7. Age 45-54 crude mortality rate decreased from 3.2 to 1.51. Age 55-64 decreased from 5.6 to 3.61. Age 65-74 decreased from 9.91 to 7.79. Age 75-84 decreased from 15.44 to 15.43. Ages 85+ increased from 21.5 to 33.1. Notably, mortality among those age 75-85 decreased by only .01, and were increased across the timespan of 2000-2020.

Conclusions

These results show that there may be differences between age groups in how mortality due to melanoma of age groups has changed from 1992-2022. While overall mortality attributed to melanoma fell during this period, mortality in those over age 85 increased. Future studies should confirm these results with different data sets and further investigate the reasons for these disparities.

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Background

Melanoma is one of the leading causes of solid tumor cancers. This study’s objective is to analyze temporal trends in melanoma-related mortality among age groups in the US before and during COVID-19. To date, no previous studies have analyzed year-to-year trends in melanoma mortality by age group using the CDC Wonder database. A 2011 analysis previously showed increasing death rates only among those over age 65 between 1992-2006.

Methods

The CDC Wonder database was used to collect data on melanoma-related mortality rates in the US from 1999-2022. Crude mortality rates per 100,000 and annual percentage change using Joinpoint regression were used to analyze yearly trends among age groups.

Results

From 1999 to 2022, overall mortality rate fell from 2.91 to 2.07, and mortality rates among all age groups decreased with the exception of those over age 85. Age 35-44 crude mortality rate decreased from 1.42 to .7. Age 45-54 crude mortality rate decreased from 3.2 to 1.51. Age 55-64 decreased from 5.6 to 3.61. Age 65-74 decreased from 9.91 to 7.79. Age 75-84 decreased from 15.44 to 15.43. Ages 85+ increased from 21.5 to 33.1. Notably, mortality among those age 75-85 decreased by only .01, and were increased across the timespan of 2000-2020.

Conclusions

These results show that there may be differences between age groups in how mortality due to melanoma of age groups has changed from 1992-2022. While overall mortality attributed to melanoma fell during this period, mortality in those over age 85 increased. Future studies should confirm these results with different data sets and further investigate the reasons for these disparities.

Background

Melanoma is one of the leading causes of solid tumor cancers. This study’s objective is to analyze temporal trends in melanoma-related mortality among age groups in the US before and during COVID-19. To date, no previous studies have analyzed year-to-year trends in melanoma mortality by age group using the CDC Wonder database. A 2011 analysis previously showed increasing death rates only among those over age 65 between 1992-2006.

Methods

The CDC Wonder database was used to collect data on melanoma-related mortality rates in the US from 1999-2022. Crude mortality rates per 100,000 and annual percentage change using Joinpoint regression were used to analyze yearly trends among age groups.

Results

From 1999 to 2022, overall mortality rate fell from 2.91 to 2.07, and mortality rates among all age groups decreased with the exception of those over age 85. Age 35-44 crude mortality rate decreased from 1.42 to .7. Age 45-54 crude mortality rate decreased from 3.2 to 1.51. Age 55-64 decreased from 5.6 to 3.61. Age 65-74 decreased from 9.91 to 7.79. Age 75-84 decreased from 15.44 to 15.43. Ages 85+ increased from 21.5 to 33.1. Notably, mortality among those age 75-85 decreased by only .01, and were increased across the timespan of 2000-2020.

Conclusions

These results show that there may be differences between age groups in how mortality due to melanoma of age groups has changed from 1992-2022. While overall mortality attributed to melanoma fell during this period, mortality in those over age 85 increased. Future studies should confirm these results with different data sets and further investigate the reasons for these disparities.

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Geographical Trends in Malignant Melanoma from 1999-2022: A CDC Wonder Study

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Background

Melanoma is the fifth leading cause of cancer in the United States. This study’s objective is to analyze geographical trends in melanoma-related mortality in the US before and during COVID-19. To date, no previous studies have analyzed geographical trends in melanoma mortality using the CDC Wonder data base. Previous literature reports Utah, Vermont, Delaware, Minnesota and New Hampshire as having the highest UV-attributable incidence rates of melanoma.

Methods

The CDC Wonder database was used to collect data on melanoma-related mortality rates in the US from 1999-2022. Age-adjusted mortality rates (AAMR) per 100,000 and annual percentage change (APC) using Joinpoint regression were used to analyze state and regional trends.

Results

From 1999 to 2019, the states with the largest increase in AAMR were Idaho (0.91) and Colorado (0.63) while Oklahoma (-1.07), Nevada (-0.94), and Texas (-0.92) saw the largest decreases. During COVID-19 (2019 to 2021), the states with the largest increase in AAMR were South Dakota (1.42), Oregon (1.09), and Montana (1.08) while Vermont (-1.02), Minnesota (-0.45), and Connecticut (-0.38) had the largest declines. From 2006-2022, except 2020, the Northeast consistently had the lowest AAMR. From 2008-2012 the West consistently had the highest AAMR. From 2013-2022, except 2015, the Midwest had the highest AAMR. From 2009 onwards, all 4 regions have seen an overall decline in AAMR with their lowest values being in 2022.

Conclusions

Idaho had the highest AAMR before COVID-19 while Oklahoma had the lowest. During COVID-19, South Dakota saw the highest AAMR while Vermont had the lowest. AAMRs have been trending downwards across all 4 regions since 2009 and the Northeast has fared the best over that period. These results should be used to increase implementation and enforcement of preventative measures to reduce UV exposure, especially in states with higher AAMRs. Further research should examine statewide sun protection programs to search for any relationship with their AAMRs.

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Background

Melanoma is the fifth leading cause of cancer in the United States. This study’s objective is to analyze geographical trends in melanoma-related mortality in the US before and during COVID-19. To date, no previous studies have analyzed geographical trends in melanoma mortality using the CDC Wonder data base. Previous literature reports Utah, Vermont, Delaware, Minnesota and New Hampshire as having the highest UV-attributable incidence rates of melanoma.

Methods

The CDC Wonder database was used to collect data on melanoma-related mortality rates in the US from 1999-2022. Age-adjusted mortality rates (AAMR) per 100,000 and annual percentage change (APC) using Joinpoint regression were used to analyze state and regional trends.

Results

From 1999 to 2019, the states with the largest increase in AAMR were Idaho (0.91) and Colorado (0.63) while Oklahoma (-1.07), Nevada (-0.94), and Texas (-0.92) saw the largest decreases. During COVID-19 (2019 to 2021), the states with the largest increase in AAMR were South Dakota (1.42), Oregon (1.09), and Montana (1.08) while Vermont (-1.02), Minnesota (-0.45), and Connecticut (-0.38) had the largest declines. From 2006-2022, except 2020, the Northeast consistently had the lowest AAMR. From 2008-2012 the West consistently had the highest AAMR. From 2013-2022, except 2015, the Midwest had the highest AAMR. From 2009 onwards, all 4 regions have seen an overall decline in AAMR with their lowest values being in 2022.

Conclusions

Idaho had the highest AAMR before COVID-19 while Oklahoma had the lowest. During COVID-19, South Dakota saw the highest AAMR while Vermont had the lowest. AAMRs have been trending downwards across all 4 regions since 2009 and the Northeast has fared the best over that period. These results should be used to increase implementation and enforcement of preventative measures to reduce UV exposure, especially in states with higher AAMRs. Further research should examine statewide sun protection programs to search for any relationship with their AAMRs.

Background

Melanoma is the fifth leading cause of cancer in the United States. This study’s objective is to analyze geographical trends in melanoma-related mortality in the US before and during COVID-19. To date, no previous studies have analyzed geographical trends in melanoma mortality using the CDC Wonder data base. Previous literature reports Utah, Vermont, Delaware, Minnesota and New Hampshire as having the highest UV-attributable incidence rates of melanoma.

Methods

The CDC Wonder database was used to collect data on melanoma-related mortality rates in the US from 1999-2022. Age-adjusted mortality rates (AAMR) per 100,000 and annual percentage change (APC) using Joinpoint regression were used to analyze state and regional trends.

Results

From 1999 to 2019, the states with the largest increase in AAMR were Idaho (0.91) and Colorado (0.63) while Oklahoma (-1.07), Nevada (-0.94), and Texas (-0.92) saw the largest decreases. During COVID-19 (2019 to 2021), the states with the largest increase in AAMR were South Dakota (1.42), Oregon (1.09), and Montana (1.08) while Vermont (-1.02), Minnesota (-0.45), and Connecticut (-0.38) had the largest declines. From 2006-2022, except 2020, the Northeast consistently had the lowest AAMR. From 2008-2012 the West consistently had the highest AAMR. From 2013-2022, except 2015, the Midwest had the highest AAMR. From 2009 onwards, all 4 regions have seen an overall decline in AAMR with their lowest values being in 2022.

Conclusions

Idaho had the highest AAMR before COVID-19 while Oklahoma had the lowest. During COVID-19, South Dakota saw the highest AAMR while Vermont had the lowest. AAMRs have been trending downwards across all 4 regions since 2009 and the Northeast has fared the best over that period. These results should be used to increase implementation and enforcement of preventative measures to reduce UV exposure, especially in states with higher AAMRs. Further research should examine statewide sun protection programs to search for any relationship with their AAMRs.

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