Racial disparities and changes in clinical characteristics and survival for vulvar cancer over time

J. Alejandro Rauh-Hain, Joel Clemmer, Rachel M. Clark, Leslie S. Bradford, Whitfield B. Growdon, Annekathryn Goodman, David M. Boruta, John O. Schorge, Marcela G. Del Carmen

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Objective The purpose of this study was to examine changes over time in survival for African-American (AA) and white women diagnosed with squamous cell carcinoma of the vulva. Study Design The Surveillance, Epidemiology, and End Results (SEER) Program for 1973-2009 was used for this analysis. We evaluated racial differences in survival between AA and white women. Kaplan-Meier and Cox proportional hazards survival methods were used to assess differences in survival by race by decade of diagnosis. Results The study sample included 5867 women, including 5379 whites (91.6%) and 488 AA (8.3%). AA women were younger (57 vs 67 years; P <.001) and had a higher rate of distant metastasis (6.1% vs 3.7%; P <.001). AA women had surgery less frequently (84.2% vs 87.6%; P =.03) and more frequently radiotherapy (24.2% vs 20.6%; P <.001). AA women had a hazard ratio (HR) of 0.84 (95% confidence interval [CI], 0.74-0.95) of all-cause mortality and 0.66 (95% CI, 0.53-0.82) of vulvar cancer mortality compared with whites. Adjusting for SEER Registry, marital status, stage, age, surgery, radiotherapy, grade, lymph node status, and decade, AA women had an HR of 0.67 (95% CI, 0.53-0.84) of vulvar cancer-related mortality compared with whites. After adjusting for the same variables, there was a significant difference in survival between AA and whites in the periods of 1990-1999 (HR, 0.62; 95% CI, 0.41-0.95) and 2000-2009 (HR, 0.46; 95% CI, 0.30-0.72) but not earlier. Conclusion AA presented at a significantly younger age compared with white women and had better survival compared with whites.

Original languageEnglish (US)
Pages (from-to)468.e1-468.e10
JournalAmerican Journal of Obstetrics and Gynecology
Volume209
Issue number5
DOIs
StatePublished - Nov 1 2013

Keywords

  • African-American
  • disparities
  • race
  • vulvar cancer

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Rauh-Hain, J. A., Clemmer, J., Clark, R. M., Bradford, L. S., Growdon, W. B., Goodman, A., Boruta, D. M., Schorge, J. O., & Del Carmen, M. G. (2013). Racial disparities and changes in clinical characteristics and survival for vulvar cancer over time. American Journal of Obstetrics and Gynecology, 209(5), 468.e1-468.e10. https://doi.org/10.1016/j.ajog.2013.07.021